海水腹腔灌流致兔电解质紊乱对血流动力学的影响

目的 观察海水腹腔灌流致电解质紊乱对血流动力学的影响,建立腹部开放伤海水浸泡模型.方法 新西兰大白兔10只,于右上腹和上腹正中作切口入腹腔,利用配制的人工海水,灌流与引流同时进行,模拟海水浸泡.观察腹腔灌流前后兔血流动力学、心律及血Na+、K+、Mg2+的变化.结果 海水腹腔灌流导致血压降低,心率变慢,未发现严重的心律失常;血清Na+、K+、Mg2+浓度均较灌流前明显增高,多元相关分析表明血压变化与血K+、Mg2+变化成显著负相关(P＜0.01);心率变化和血清K+、Mg2+变化成显著负相关(P＜0.01),与血清Na+变化成显著正相关(P＜0.01).结论 海水腹腔灌流可导致电解质和血流动力学紊乱,高钾高镁血症是导致血压降低、心率减慢的重要原因.本模型可用于分析海水浸泡后电解质对血流动力学的影响.

Effects of abdominal cavity seawater perfusion on electrolyte and hemodynamics in rabbits

Objective To investigate effects of abdominal cavity seawater perfusion on serum electrolyte concentration and hemodynamics in rabbits. Methods Ten healthy New Zealand rabbits were used for the experiment. Incisions of the abdominal cavity were made in right upper and middle epigastria. Artificial seawater perfusion and draining were performed simultaneously to simulate seawater immersion. Changes in serum electrolyte concentration,blood pressure and heart rate were observed both before and after abdominal cavity seawater perfusion. Results Blood pressure and heart rate decreased significantly following abdominal cavity seawater perfusion,but no serious arrhythmia was noted. Concentrations of serum sodium,potassium and magnesium increased significantly,when they were compared with that before perfusion. Multiple correlation analysis indicated that changes in blood pressure and heart rate were inversely correlated with changes in serum potassium and magnesium (P ＜ 0. 01 ),whereas changes in blood pressure and heart rate were positively correlated with serum sodium ( P ＜ 0. 01 ). Conclusions Abdominal cavity seawater perfusion could induce severe disturbance of hemodynamics and electrolytes. Hyperpotassemia and hypermagnesemia might be the culprit for the decrease of blood pressure and heart rate. And this animal model could be used for the evaluation of effects of electrolytes on hemodynamics following seawater perfusion.