心包切开术对急性肺栓塞犬血液动力学的影响

为探讨心包切开对急性肺栓塞右室压力超负荷引起的血液动力学损害的影响，我们在一组（６只）急性肺栓塞溶栓对照犬，于注栓约５．０小时后开胸心包切开，阔胸０．５小时后复查血液动力学各参数。急性肺栓塞使肺动脉压力及肺血管阻力明显升高，溶栓疗法使肺动脉压力及肺血管阻力明显降低，对照组两参数在栓塞后随时间无明显变化。两组心排血量在肺栓塞后随时间呈下降趋势，但无显著性下降、心包切开使对照大周围动脉压明显下降，而肺动脉平均压和肺血管阻力无显著性变化。心包切开术在无明显心排血量下降犬不能逆转或改善血液动力学损害。

The effects of pericardial incision on haemodynamics in acute experimental pulmonary embolism

To clarity the magnitude of contribution of pericardial incision on haemodynamic amelioration, six dogs with acute pulmonary embolism used as thrombolytic cnotrols had its pericardium incised 5 .0 hoars after aubologous blood colot infusion. The haemodynamic parameters were remesured 0.5 home post chest closure. Pulmonary artery pressure and pulmonary resistance increased markedly after pulmonary embolism, which were lowered progressively and significant by thrombolytic therapy in contrary with control dogs.There was no significant decrease in cardiac output in both thrombolytic and control group dogs throughout the experimental session. Systemic blood pressure decreased significantly, whereas both pulmonary arterial pressure and pulmonary vascular resistance had no significant changes post pericardial incision. It was revealed that pericardial incisions have no beneficial effects on cardiac function in control dogs without severe right heart failure.