摘要
目的 探讨感染性休克时新西兰大白兔全身和空肠氧摄取率变化的规律。方法 应用大肠杆菌内毒素制备兔感染性休克模型。对照组 (n =5只 ,注射等量生理盐水 )和感染性休克组 (n =1 0只 ) ,分别做右侧颈外静脉至右心房、股动脉、肠系膜上静脉近端分支插管、抽血行血气分析 ,观察两组不同时间段全身和空肠氧摄取率及血气参数的变化。结果 感染性休克组全身氧摄取率似有增加 ,但与对照组相比 ,差异无显著性意义 (P >0 0 5 ) ;而小肠氧摄取率逐渐增加 ,与基础值和对照组相比 ,差异有显著性意义 (P <0 0 5 ) ;右心房血 (混合静脉血 )和肠系膜上静脉近端血pH随休克时间延长逐渐降低 ,BE负值逐渐增大 ,两者呈平行关系 ,与基础值和对照组相比 ,差异有显著性意义 (P <0 0 5 )。结论 感染性休克时 ,全身氧摄取率不变 ,空肠局部氧摄取率增加 ,但组织缺氧始终存在 。
Objective To observe alterations of systemic and jejunum oxygen extraction in rabbits with septic shock.Methods Anesthetized New Zealand white rabbits[2 20±0 15]kg were randomly divided into septic shock group( n =10,receiving a continuous infusicn of E.ColiO 111 B 5)and control group( n =5,receiving normal saline).The right jugular vein(right atrium),left femoral artery,and the approximal branch of superior mesenteric vein were cannulated.Mean arterial pressure(MAP)and heart rate were monitored.Half hour interval from o to 2 5 hours after infusion of E.ColiO 111 B 5 and NS,arterial and venous blood samples were simultaneously collected,and blood gas analysis were made.Systemic O 2 extraction ratio (SO 2ER)and intestine O 2ER(IO 2ER)were calculated.Results In the Septic shock group,SO 2ER slightly increased,but did not show significant difference compared with the control group( P >0 05).However,the pH values and base excess of the blood samples from right jugular vein decreased markably with good correlation after 1 5 hours and showed sighificant difference compared with the control group( P <0 05).Whereas the IO 2ER increased from 0 24 to 0 44,gradually increased at 0 5 hour time point and showed significant difference ( P <0 05)compared with control group.Meanwhile,the pH and base excess of the blood samples from superior mesenteric vein decreased accordingly.Conclusion During septic shock,the hemodynamic shows blood distribution coas unnormal while the cardiac output could be normal even higher which is different from other kinds of shock with lower cardiac output.therefore,the oxygen delivery and O 2ER could be kept normal or even higher in septic shock while the tissues are poorly perfused.Although IO 2ER remains high in order to meet its high metabolic needs during septic shock ,the higher O 2ER may not be able to improve the local oxygenatial which may be caused by mitochondrion dysfunction in cells. [
出处
《中华急诊医学杂志》
CAS
CSCD
2003年第5期295-297,共3页
Chinese Journal of Emergency Medicine
