腹腔开放伤并海水浸泡血气酸碱有关指标的变化分析

目的　研究腹腔开放伤后海水浸泡对机体动脉血气的影响。方法　 2 1只犬致伤后随机分为对照组 (n=7)、等渗盐水浸泡组 (n=7)和海水浸泡组 (n=7)。对照组为单纯腹外伤 ,后两组动物致伤后腹部分别浸入等渗盐水、海水中 ,观察各组动物动脉血气、血浆渗透压及肿瘤坏死因子 (TNF)水平的变化。结果　对照组和等渗盐水浸泡组致伤前后动脉血气、血浆渗透压及 TNF变化不明显 ;海水浸泡组致伤后 6 0 min始血 p H、Pa O2 及 BE水平均较对照组和等渗盐水浸泡组显著降低 (P<0 .0 5 ) ,而血浆渗透压与 TNF水平则显著升高 (P<0 .0 1) ;致伤后 12 0 min始海水浸泡组 Pa CO2 均较对照组和等渗盐水浸泡组显著升高 (P<0 .0 1)。结论　腹腔海水浸泡可引起机体出现低氧血症、高碳酸血症及酸中毒。

Changes of indexes related to artery blood-gas after seawater immersion in dogs with open abdominal wound

Objective To determine the influence of seawater immersion on artery blood-gas in dogs with open abdominal wound.Methods A dog model of open abdominal wound was established.Twenty-one dogs were randomly divided into three groups.Control group ( n =7) were subjected to simple open abdominal wound.Isotonic saline immersion group ( n =7) and seawater immersion group ( n =7) was immersed into isotonic saline and seawater respectively after wound infliction.Changes of blood-gas,plasma osmotic pressure,activity of tumor necrosis factor (TNF) were observed.Results No significant changes of blood-gas,plasma osmotic pressure and TNF activity were found between the control group and the isotonic saline immersion group.Levels of pH,PaO-2 and BE were decreased,but levels of plasma osmotic pressure and TNF activity were increased significantly in the seawater immersion group 60 min after abdominal seawater immersion ( P <0.05 or 0.01,compared with control group or isotonic saline immersion group).PaCO-2 level was increased significantly in seawater immersion group 120 min after abdominal seawater immersion ( P <0.01,compared with control group or isotonic saline immersion group).Conclusions Seawater immersion after open abdominal wound can result in anoxemia,hypercapnia and acidosis.