犬腹腔海水浸泡伤不同清创方法及补液方案的救治效果

目的观察不同腹腔清创方法及补液方案对腹腔海水浸泡伤实验犬的救治效果。方法杂种犬32只，随机均分为生理盐水初步补液救治组（A组）、生理盐水充分补液救治组（B组）、321胶体液初步补液救治组（C组）及321胶体液充分补液救治组（D组），观察每一组腹腔海水浸泡后的存活情况、平均动脉压（MAP）、血浆渗透压、血浆乳酸水平、血浆丙二醛（MDA）及组织病理学变化。结果（1）C、D组长期存活率分别为62．5％（5／8）、100％（8／8），显著高于A、B两组0（0／8）（P〈0．05）。（2）腹腔海水浸泡后6hB、D两组MAP水平显著高于A、C两组，而血浆渗透压、血乳酸及MDA水平则显著低于A、C两组，D组血浆渗透压水平显著低于B组（P〈0．05）；腹腔海水浸泡后12hD组MAP水平显著高于B组，而血乳酸及MDA水平则显著低于B组（P〈0．05）。（3）A、B组腹腔海水浸泡后24h腹腔器官病理改变以化脓性炎症反应为主，而C、D组则以充血水肿性炎症反应为主。结论腹腔海水浸泡伤战地早期完成初步清创及补入足量321胶体液能有效减轻机体腹腔感染，提高创伤动物生存率。

Effects of different kinds of celiac debridement and infusion on celiac seawater immersion wound in dogs

Objective To observe the effects of different kinds of celiac debridement and different kinds of infusion on celiac seawater immersion wound in dogs. Methods Thirty-two dogs were randomly divided into primary infusion with saline group (group A) , infusion with sufficient saline group (group B) , primary infusion with 321 liquid containing colloid group (group C) and infusion with sufficient 321 liquid containing colloid group ( group D). Survival rate, mean artery pressure ( MAP) , plasma osmotic pressure, malondioldehyde(MDA) and lactic acid (LA) were measured after celiac seawater immersion in each group. Pathological changes were examined after the death of dogs. Results (1) Long-time survival rate was 62. 5% (5/8) and 100% (8/8) in group C and D,which were significantly longer than those in group A and B (0/8) (P < 0.05). (2)6 h after celiac immersion, MAP in group B and D became higher than that in group A and C, however,plasma levels of osmotic pressure,MDA and LA in group B and D became lower than those in group A and C (P < 0.05). At the same time, the plasma osmotic pressure in group D was significantly lower than that in group B(P<0.05).12h after celiac immersion,the MAP in group D became higher than that in group B and the MDA and LA became lower than those in group B (P <0.05). (3)24h after celiac sweater immersion, the main pathological characteristics of celiac organs were purulent inflammation in group A and B, edema and congestion in group C. Conclusions Early infusion of sufficient 321 liquid containing colloid and celiac debridement can alleviate celiac infection and improve the survival rate of dogs with celiac seawater immersion, wound.