摘要
目的 观察大剂量地塞米松对犬严重肺冲击伤的治疗效果。方法 将 18条成年犬随机分为对照组 (T0 )与治疗组 (Tdex) ,用BST 1生物激波管造成犬严重肺冲击伤。T0 组伤后即刻给予半卧位、吸氧、补液、抗感染等处理 ;Tdex组在以上处理基础上分 3次 (伤后 0 .5、8、12h)给予总量 11mg/kg大剂量地塞米松治疗 ,于致伤后 0、0 .5、2、4、6、8、12h检测血流动力学与血气指标 ,观察伤后 2 4h内平均肺体指数及死亡率。结果 T0 组伤后血流动力学及血气指标发生严重紊乱 ,HR、sBP出现一过性下降 ,CI、CO、LCW、PaO2 及SO2 指标明显下降而SVR、SVRI显著增高 ,伤后 2 4h肺体指数为 ( 1 83±0 3 8) % ,死亡率为 40 % ;Tdex组伤后HR、sBP、CI没有明显下降 ,与T0 组相比 ,伤后 0 .5hsBP显著增高 (P <0 .0 5 ) ,伤后 4～8hLCW也显著增高 (P <0 .0 5 ) ,伤后 6～ 12hSVR显著降低 (P <0 .0 1) ,SVRI也显著降低 (P <0 .0 5 ) ,伤后 2 4h肺体指数仅为 ( 1.3 2± 0 .2 1) % (P <0 .0 5 ) ,死亡率仅为 14 .3 % ,但对血气指标紊乱没有明显改善。
Objective To observe the effect of high dose dexamethasone treatment on canine severe lung blast injury. Methods A total of 18 mature dogs were randomly divided into control group(T0) and treatment group(Tdex). BST 1 type bio shock tube was used to induce severe lung blast injury. After injury, the animals in 2 groups were both treated with semi reclining position, oxygen supply, fluid replacement and antibiotic immediately, but the animals in Tdex were additionally treated with high dose dexamethasone at the total dose of 11 mg/kg administered at 0.5, 8 and 12 h. Hemodynamics and blood gas were detected at 0.5, 2, 4, 6, 8 and 12 h following injury. Index of lung weight/body and mortality rate at 24 h were also observed. Results After blast injury, hemodynamics and blood gas were disordered significantly in T0 group. HR, sBP decreased transiently but CI, CO, LCW, PaO 2 and SO 2 decreased markedly whereas SVR and SVRI increased markedly. The index of lung/body weight was 1.83%±0.38% and mortality rate was 40% at 24 h following injury. However, no significant decrease in HR, sBP and CI was found in Tdex group. Compared to those in T0 group, sBP was significant higher at 0.5 h and LCW was higher at 4-8 h ( P <0.05). On the contrary, SVR, SVRI were significantly lower during 6-12 h ( P <0.01 or P <0 05); the index of lung/body weight was 1.32%±0.21% in Tdex, which was also significantly lower than that in Tdex group ( P <0.05). The mortality rate was only 14.3%. But dexamethasone treatment had no obvious effect on the disorder of blood gas. Conclusion High dose dexamethasone plays an important role in the treatment of canine severe lung blast injury.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2003年第11期935-937,共3页
Journal of Third Military Medical University
基金
全军"九五"指令性课题 ( 96L0 4 0 )
关键词
肺冲击伤
地塞米松
血流动力学
血气
lung blast injury
dexamethasone
hemodynamics
blood gas
