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目的观察海水中火器伤犬早期动脉血气和酸碱平衡的变化,为早期救活方案的拟定提供实验依据。方法将17只普通级比格犬分为海水组(n=14)和地面组(n=3)。两组于(33．75±25．29)min经右颈动脉导管采血检测动脉血气和酸碱平衡各指标,分析其致伤前后的变化。结果海水中火器伤伤后动脉血氧分压(PaO_2)、氧分压与肺泡氧分压之比(PaO_2/PAO_2)、氧分压与吸氧浓度之比(PaO_2/FiO_2)、二氧化碳分压(PaCO_2)、氧饱和度(SaO_2)、碱剩余(BE)、实际碳酸氢根(AB)和二氧化碳结合力(CO_2CP)升高,肺泡内动脉氧分压(PAO_2)、肺泡氧分压差[P(A-a)O_2]、pH、标准碳酸氢盐(SB)和总二氧化碳(T-CO_2)下降,上述变化之差异均具有统计学意义(P＜0．01),此外,血氧含量(CaO_2)下降且差异有统计学意义(P＜0．05),阴离子间隙(AG)的改变差异虽无统计学意义(P＞0．05),但有上升趋势。结论海水中火器伤伤后早期动脉血气和酸碱平衡明显失调,表现为低氧血症和高碳酸血症以及以代谢性酸中毒、呼吸性酸中毒代偿期和代谢性碱中毒为主的呼吸性酸中毒型三重酸碱失衡,临床救治时应纠正这些变化。
Objective To observe the changes of early arterial blood gas and acid-base balance in firearm-injured dogs in seawater and provide experimental evidence for the formulation of early rescue programs. Methods 17 common beagle dogs were divided into seawater group (n = 14) and ground group (n = 3). The arterial blood gas and acid-base balance were measured at (33.75 ± 25.29) min in the right carotid duct to analyze the changes before and after the injury. Results PaO2, PaO_2 / PaO_2, PaO_2 / FiO_2, partial pressure of carbon dioxide PaCO_2, SaO_2, BE, AB and CO_2CP, PAO_2 and alveolar oxygen pressure difference [ P (Aa) O_2], pH, SB and T-CO_2 decreased, the difference was statistically significant (P <0.01). In addition, the content of CaO_2 (P <0.05). There was no significant difference in anion gap (AG) between the two groups (P> 0.05), but there was an upward trend. Conclusion In the early stage of firearm injury in seawater, the arterial blood gas and the acid-base balance were obviously imbalanced, showing hypoxemia and hypercapnia as well as metabolic acidosis, respiratory acidosis decompensation and metabolic alkalosis Respiratory acidosis triple acid-base imbalance, clinical treatment should correct these changes.