失血性休克时胃粘膜内pH与组织氧合监测的实验研究

目的 进一步探讨粘膜内pH与值肠粘膜组织氧合的关系。方法 以失血性休克大鼠为模型，根据胃内PCO2和同时测得的动脉血HCO3^-浓度，通过Henderson-Hasselbalch公式间接测定胃粘膜内pH(pHi)，同时测定动脉血，混合静脉血，门静脉乳酸（Lacp)及动脉血，混合静脉血气分析。结果 失血性休克时，pHi与门静脉乳酸（Lacp)显降低，两呈线性关系（r=-0.88)，pHi的降低不仅与胃肠粘膜的氧合障碍有关，同时还与全身组织氧合不足有关，失血性休克时，pHi的降低与胃肠粘膜的病理性损害一致。结论 pHi的变化可早期反映肠道及全身组织氧合情况，可作为重症监护的一个重要指标。

Experimental studies of gastric intramucosal pH and tissue oxygenation at hemorrhagic shock

ObjectiveTo find out the relationship between gastric intramucosal pH and intestinal tissue oxygenation. MethodsA simultaneous determination of arterial blood HCO - 3 concentration and intraluminal PCO 2 was conducted to calculate gastric intramucosal pH(pHi) by using Henderson-Hasselbalch equation.ResultsThere was a great decrease in pHi and portal lactate concentration (Lac p ) at hemorrhagic shock. pHi reflected not only the intestinal tissue oxygenation but also the systemic oxygenation, and it correlated markedly with gastrointestinal mucosal damage. Conclusion pHi may be a good parameter to indicate the adequacy of tissue oxygenation and it may be a good index in critical care.