【摘要】 目的：通过观察急性等容血液稀释（ＡＮＨＤ）时组织ＤＯ２、ＶＯ２的变化，寻找ＡＮＨＤ的生理极限。方法：１０只健康成年杂种犬，用戊巴比妥钠、维库溴铵静脉麻醉后行气管内插管，控制呼吸。每只犬进行三个水平即中度（ＨＤ１）、深度（ＨＤ２）、极深度（ＨＤ３）ＡＮＨＤ，然后回输自家血，测定血流动力学指标，动脉及混合静脉血气，动脉血乳酸等，以观察ＡＮＨＤ时ＤＯ２、ＶＯ２的变化。结果：ＨＤ１（ＨＣＴ＝１９．４３％±１．９７％），ＨＤ２（ＨＣＴ＝１４．７３％±０．９９％）时，ＤＯ２分别降低４２％和５２％，ＥＲＯ２分别升高４０％和８８％，ＣＩ升高４１％和４８％，而ＶＯ２只降低４．８％和５．２％，动脉血乳酸末升高。ＨＤ３（ＨＣＴ＝９．５０％±０．８８％）时，ＤＯ２降低７３％，ＥＲＯ２升高２００％，ＣＩ降低，ＶＯ２降低３５％，动脉血乳酸显著增加。回输自家血后，ＤＯ２、ＶＯ２及血乳酸均恢复。结论：中、深度ＨＤ时，ＤＯ２减少，ＶＯ２可通过增加ＥＲＯ２和ＣＩ代偿；极深度ＨＤ时ＶＯ２降低显著，出现无氧代谢，ＨＤ达极限。更多还原

【Abstract】 Objective:To evaluate the effects of acute normovolemic hemodilution(ANHD) on systemic oxygen delivery(DO 2) and oxygen consumption(VO 2) for determining the acceptable limit of hemodilution(HD) Method:Ten healthy hybrid dogs,weighing 11 18kg,were anesthetized with 6% sodium pentobarbital,endotracheal intubation was facillitated with vecuronium,and ventilation was controlled The different degrees of ANHD,namely moderate(HD 1,HCT=19 43%),severe(HD 2,HCT=14 73%) and extreme(HD 3,HCT=9 50%)HD,were accomplished by progressively exchanging whole blood with 4% Gelofusion Blood gases,plasma lactate level (LA)and hemodynamic veriables were measured prior to HD and 30 mins following every degree of hemodilution and 15 mins after reinfusion Result:During the HD 1 and HD 2,Oxygen delivery(DO 2) decreased by 42% and 52% respectively (P<0 05);oxygen extraction ratio(ERO 2) increased by 40% and 88% respectively(P<0 05);cardiac index(CI) increased by 41% and 48% respectively(P<0 05);but oxygen consumption(VO 2) and plasma LA level did not change During the HD 3,DO 2 decreased by 73%(P<0 05);ERO 2 increased by 200%(P<0 05);CI decreased;VO 2 decreased by 35% and plasma LA level increased significantly(P<0 05) After reinfusion,DO 2 rose approximately to baseline;VO 2 also increased and much greater than the baseline(P<0 05),simultaneously plasma LA level decreased to the baseline Conclusion:Acute normovolemic hemodilution can be well tolereted until HCT drops to about 10% in dogs更多还原