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目的 探讨热射病休克的抢救方法。方法 将家兔热暴露至休克发生 ,然后将其置于室温下。用传统的冷水浸泡、冷生理盐水 (NSS)腹腔灌洗和冷腹膜透析液 (PDS)腹腔灌洗方法抢救 ,观察动物中心体温的变化和存活时间 ,以及冷PDS腹腔灌洗组中血液K+ 、pH值、尿素氮和肌肝的变化。结果 ①冷水浸泡组 (n =8) ,直肠温度 (Tr)和食道温度 (Te)下降缓慢 ,平均存活 (16 3± 2 5 2 )分钟。②冷NSS腹腔灌洗组 (n =10 )和冷PDS腹腔灌洗组 (n =10 ) ,下丘脑温度 (Tb)、Tr和Te下降迅速 ,血压回升 ,平均存活时间分别为 (83 2± 47 8)、(98 5± 6 7 4)分钟 ,比冷水浸泡组存活时间显著延长。③冷PDS腹腔灌洗组中休克时血K+ 升高 ,酸中毒明显 ,透析 30分钟后得以改善 ,而显著升高的尿素氮和肌酐则改变不明显 ,存活时间比冷NSS腹腔灌洗组延长。结论 冷液腹腔灌洗是抢救热射病休克有效的方法 ,尤其是冷PDS腹腔灌洗 ,为进一步救治赢得了宝贵的时间。
Objective To discuss the method of rescuing heat shock disease. Methods Rabbits were exposed to shock by heat exposure and then left at room temperature. Conventional cold water immersion, cold saline (NSS) peritoneal lavage and cold peritoneal dialysis fluid (PDS) peritoneal lavage method to rescue, observation of animal center temperature changes and survival time, and cold PDS peritoneal lavage group blood K + pH, urea nitrogen and muscle changes in the liver. Results ① In the cold water immersion group (n = 8), the rectal temperature (Tr) and esophageal temperature (Te) decreased slowly with an average survival of (16 3 ± 25 2) minutes. ② The temperature of hypothalamus (Tb), Tr and Te decreased rapidly in NSS group (n = 10) and cold PDS group (n = 10), blood pressure rose and mean survival time was (83 2 ± 47 8), (98 5 ± 6 7 4) minutes, significantly longer than the cold water immersion group survival time. ③ cold PDS peritoneal lavage in shock when blood K + increased acidosis significantly dialysis improved after 30 minutes, while significantly elevated urea nitrogen and creatinine was not changed significantly survival time longer than the cold NSS lavage . Conclusion Cold fluid peritoneal lavage is an effective method to rescue heat shock disease, especially cold PDS peritoneal lavage, which has won precious time for further treatment.