腹腔筋膜室综合征对兔循环及呼吸功能的影响

摘要：目的制作家兔腹腔筋膜室综合征（ACS）模型，研究ACS对兔循环、呼吸功能及血液电解质水平的影响。方法将24只新
西兰兔平均分为4组，分别为对照组、ACS5组（IAP=5 mmHg）、ACS10组（IAP=10 mmHg）和ACS20组（IAP=20 mmHg），ACS模型
通过腹腔内出血（股动脉采血输入腹腔）合并腹腔内高压（注入不同量的氮气）实现，并在IAH后1 h观察兔血液动力学指标：左
心室收缩压（LVSP）、左心室舒张末期压（LVEDP）、左心室内压力最大变化速率（±dp/dt max）、动脉收缩血压（SP）、动脉舒张血压
（DP）、心率（HR）以及中心静脉压（CVP）；呼吸功能指标：呼吸频率（RR），动脉血氧分压（PaO2），动脉二氧化碳分压（PaCO2），动
脉血碳酸氢根HCO3
-]；血液酸碱度及血K+浓度。结果ACS20组循环功能及呼吸功能指标与正常组相比有显著下降，且有酸中
毒及血钾升高（P均<0.05）；ACS10组循环功能指标及除RR及PaO2外的呼吸功能指标均有显著下降，但下降幅度小于ACS20组，且
同样有酸中毒及血钾升高（P均<0.05）；ACS5组除LVSP及HR有下降外（P<0.05），其余指标均无明显改变。结论腹内出血合并
腹内高压对兔循环、呼吸功能有一定损害并导致酸碱平衡及电解质紊乱，且可导致ACS发生。

Effects of abdominal compartment syndrome on circulation and respiratory function in rabbits

Objective To establish a rabbit model of abdominal compartment syndrome(ACS) and evaluate the impact of ACS on cardiovascular and respiratory functions and blood electrolyte levels in rabbits.Methods Twenty-four New Zealand rabbits were randomly allocated into 4 equal groups,namely the normal control group,ACS5 group intra-abdominal pressure(IAP)=5 mmHg],ACS10 group(IAP=10 mmHg) and ACS20 group(IAP=20 mmHg).ACS model was established by intra-abdominal bleeding(IAB) with intra-abdominal hypertension(IAH).All the data were recorded 1 h after inducing IAH including cardiovascular parameters(LVSP,LVEDP,±dp/dt max,SP,DP,HR,CVP),respiratory function(RR,PaO2,PaCO2,),blood pH,and electrolyte level().Results Compared with those in the normal control group,ACS20 group showed significantly decreased LVSP,LVEDP,±dp/dt max,SP,DP,HR,RR,PaO2,,and blood pH but increased CVP,PaCO2,and K+(P<0.05).In ACS10 group,all the parameters except for RR and PaO2 showed similar changes as seen in ACS20 group(P<0.05) but with lower amplitudes of variations.In ACS5 group,only LVSP and HR were reduced remarkably(P<0.05) while the other parameters showed no significant variations.Conclusion IAB plus IAH may cause damage to the cardiovascular and respiratory functions and lead to ACS in rabbits.