【摘要】 目的探讨急进高原火器伤血流动力学、血气及血生化指标的改变及丹参(SM)、地塞米松(DEX)单用或伍用对其的疗效。方法在西藏拉萨(海拔3 658m),采用五三式滑膛枪发射1.03g钢珠致伤急进高原的四川长白山猪后肢,观察火器伤后血流动力学、血气及血生化指标的改变及SM、DEX单用和伍用的治疗作用。结果急进高原猪火器伤后,平均肺动脉压(MPAP)、肺动脉楔压(PAWP)呈上升趋势,伤后6小时达最高,心输出量(CO)伤后1小时呈升高趋势,随后呈下降趋势;平均动脉压(MAP)、心率(HR)各组致伤前后无显著变化;单纯致伤组伤后动脉血PaO2、PaCO2显著下降,6小时最低(P<0.05);24小时血肌酐(Cr)水平显著升高(P<0.05);谷丙转氨酶(ALT)活性呈上升趋势;各组伤后K+均呈升高趋势,但Na+、C l-及血氧饱和度(O2STA)致伤前后无显著变化。SM、DEX单用和伍用均可不同程度地降低MPAP、PAWP,增加CO;伤后24小时动脉血PaO2基本恢复至伤前水平;血液Cr水平降低(P<0.05),其中以DEX单用和SM、DEX合用组效果最好。结论SM、DEX能改善急进高原火器伤的血流动力学指标,减轻缺氧及创伤所致的组织损伤,改善重要脏器的功能。更多还原

【Abstract】 Objective To study hemodynamic changes of firearm injuried pigs at acute exposed high altitude,and the effects of treatment with salvia-miltiorrliza（SM） and dexamethasone（DEX）.Methods Sichuan Changbaishan pigs acutely exposed to Lhase,Tibet（3658 meters above the sea level）were injured with steel balls.The hemodynamics,blood gas and blood biochemical parameters were measured after bullet wound,and all of the changes above after the treatment of SM or DEX alone and combined were observed.Results The level of mean pulmonary arterial pressure（MPAP）,pulmonary arterial wedge pressure（PAWP） and cardiac output（CO） were increased after injury.There was no change in MAP and HR after injury.The level of PaO₂ and PaCO₂ of simple injury group significantly decreased after injury.The level of creatine（Cr） significantly increased after injury.K⁺ increased in all the groups after injury.Na⁺,Cl^- and O₂STA were not changed in all the groups during the observation.Compared with the injury group,SM or DEX and combined use of both drugs could decrease the MPAP,and PAWP,and increase CO.PaO₂of arterial blood was restored to the normal level,and the level of Cr decreased after the treatment.The most beneficial effects were found in DEX group and DEX combined with SM group.Conclusion SM and DEX can improve the hemodynamic parameters in the pigs after bullet wound at high altitude,and improve the vital organ functions.更多还原