主动脉转流对腹主动脉阻断所致血液动力学等改变的影响

目的:探讨不同流量主动脉转流对腹主动脉暂时性阻断时全身血液动力学等改变的影响。方法:实验建立在小猪腹腔动脉开口以上阻断腹主动脉1h和同时应用辅助主动脉转流的模型,监测血液动力学的变化,并观察组织学的改变。结果:阻断组发生了明显的血液动力学紊乱,尿量明显减少,代谢性酸中毒也极为明显,肝、肾和小肠组织及超微结构均发生了明显的病变。在主动脉转流组血液动力学的紊乱得到明显改善。结论:腹主动脉阻断1h将造成严重的全身血液动力学紊乱,当转流量达到原腹主动脉血流量的70%时主动脉转流能较好地防止这一损伤改变。

The impact of aortic bypass on hemodynamic changes caused by abdominal aorta occlusion

AIM: To investigate the impact of aortic bypass of different flow on hemodynamic changes caused by abdominal aorta occlusion. METHODS: A pig ischemic model was established by cross-clamping of the abdominal aorta above the celiac artery for 1 hour, and aortic bypass was used at the same time. The different flow of aortic bypass were placed between the proximal abdominal aorta and the left common iliac artery by using a roller pump. Two kinds of bypass flow rate were used with 50% and 70% of the volume of abdominal aorta flow cross-clamped site. The major hemodynamic changes were monitored during the different aortic cross-clamping and unlamping periods. RESULTS: All pigs without bypass (simple cross-clamping group) developed severe hemodynamic disturbance . Proximal arterial pressure rose markedly and distal arterial pressure dropped drastically during the period of cross-clamping, and there was a significant drop in the arterial pressure after unclamping. Heart rate increased obviously, and urine outputs decreased significantly compared with pre-clamping. The animals also developed a serious metabolic acidosis. In 70% flow group, the aforementioned values improved significantly when compared with that of 50% flow group. CONCLUSION: There was a severe hemodynamic alteration when the proximal abdominal aorta was cross-clamped for 1 hour, and the injury changes could be well prevented when the flow of aortic bypass was up to 70% of the volume of abdominal aorta flow.