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目的探讨高原肢体枪弹伤后动物循环呼吸系统的改变情况。方法将24头实验猪随机分为高原战时致伤组(GZ)、高原平时致伤组(GP)和平原平时致伤组(PP),分别于伤前、伤后不同时相点进行心脏功能测定,抽动脉血进行血气分析。结果 (1)高原两组动物致伤后全身肌肉持续强烈痉挛,皮肤呈苍白色,程度较平原严重,持续时间较平原地区久,此后转变为红色并逐渐转为暗红色;大多在伤后几十秒钟后出现呼吸暂停,继之呼吸急促,以后逐渐平稳并慢慢转为深大呼吸,呼吸频率较正常明显减慢、呼吸幅度明显加大。(2)高原火器伤后早期心率加快、心肌收缩力显著增强,但是心肌的顺应性降低,心脏每博输出量和每分输出量均较伤前降低,1h时显著低于伤前水平。(3)高原战时组伤前动物就存在显著的呼吸性碱中毒和代谢性酸中毒,伤后早期呼吸频率较平原快,过度通气较为严重而持久,主要表现为呼吸性碱中毒,并出现失代偿;在酸碱紊乱的同时,动物也存在显著的低氧血症。(4)高原肺脏远达效应的发生率最高为53.85%,心脏发生率为19.23%。结论高原肢体枪弹伤后,外周血管收缩强烈,心肌顺应性降低,心功能下降,发生严重的酸碱紊乱和低氧血症,程度较平原地区重,持续时间较平原地区长。
Objective To investigate the changes of circulatory system of animals after gunshot wounds on the plateau limbs. Methods Twenty-four experimental pigs were randomly divided into three groups: GZ, GP and PP; Function determination, twitch blood for blood gas analysis. Results (1) All the animals in the plateau sustained strong spasm after the injury. The skin was pale and the skin was more serious than the plain. The duration was longer than that of the plain. After that, it changed to red and turned to dark red. Ten seconds after the onset of apnea, followed by shortness of breath, then gradually steady and slowly turned into deep breathing, respiratory rate was significantly slower than normal, significantly increased respiratory rate. (2) In the early stage of the plateau firearm injury, the heart rate accelerated and the myocardial contractility was significantly increased. However, the compliance of the myocardium decreased. The cardiac output per cardiac output and the output per minute were lower than those before the injury, and were significantly lower than those before the injury at 1h. (3) There were significant respiratory alkalosis and metabolic acidosis in pre-injury wounded animals in the plateau wartime. The early post-traumatic respiratory rate was faster than that of the plain and the hyperventilation was more serious and persistent. The main manifestations were respiratory alkalosis and appeared Decompensated; in acid-base disorders, animals also have significant hypoxemia. (4) The highest incidence of lung up-reaching effect of plateau was 53.85% and the incidence of heart was 19.23%. CONCLUSIONS: After limb bullet wounds, peripheral blood vessels contracted strongly, myocardial compliance decreased, heart function decreased, and serious acid-base disorders and hypoxemia occurred. The severity of the limbs was heavier than that of the plain and lasted longer than that of the plain.