口腔黏膜二氧化碳分压与大鼠失血性休克程度的相关性研究

通过研究大鼠失血过程中口腔黏膜二氧化碳分压（PbuCO2）与失血性休克程度的相关性,证明PbuCO2可用于失血性休克早期救治过程中休克程度的评价.25只Wistar大鼠随机分成5组,用戊巴比妥钠麻醉后,除假手术组外,其余4组失血30min,失血量分别达到总血容量的25%,30%,35%和40%.用PbuCO2检测装置对大鼠口腔黏膜的PCO2进行连续、无创检测,并对动脉血压（ABP）、心输出量（CO）、心电（ECG）和呼吸（RES）进行实时或不间断的检测,另外不间断抽取动脉血进行血液检验.失血后30min时,除40%小组部分动物死亡外,其余存活动物的ABP,CO,ECG,RES,血气和电解质都没有显著差异,而仅失血15min后,相对上述生理指标,PbuCO2表现出极显著的差异性（P〈0.01）.实验证明,PbuCO2不仅能够检测失血后组织灌注的变化,而且与ABP,CO,血气和电解质等指标相比,在区分不同程度的休克时更具有一致性、准确性和灵敏性.结果显示,PbuCO2的连续无创检测可有效地评价失血性休克程度,指导早期救治.

Correlation Between Buccal Mucosal Carbon Dioxide Partial Pressure and the Severity of Hemorrhagic Shock in Rats

Through the research on the correlation between buccal mucosal carbon dioxide partial pressure and the severity of hemorrhagic shock in a rat model, we demonstrated that PbuCO₂ is available and reliable for evaluating blood loss for its early management of hemorrhagic shock. Twenty-five Wistar rats anesthetized with sodium pentobarbital were randomly divided into five groups, in addition to the sham operation group, and the other four groups were bled over 30 min in amounts estimated to be 25%, 30%, 35%, or 40% of total blood volume. Buccal mucosal PCO₂ was measured by a continuous and non-invasive PbuCO₂ meter, and arterial blood pressure (ABP), cardiac output (CO), ECG and respiratory (RES) were monitored in real-time and continuously, and arterial blood test. After 30 min, some animals with an estimated 40% blood loss died. In the remaining animals, ABP, CO, ECG, RES, blood gas and electrolytes among animals with 35%, 30%, and 25% blood loss were not significantly different. Compared with all the above physiological parameters, only within 15 min, PbuCO₂ manifested notable significance (P<0.01). The experiment indicated that PbuCO₂ not only is able to detect changes in tissue perfusion after blood loss, but also provides more consistency, accuracy and sensitivity than ABP, CO, blood gases and electrolytes to discriminate between different blood loss. The results showed that continuous non-invasive mesurement of PbuCO₂ can effectively evaluate hemorrhagic shock so useful as to guide for the immediate management of hemorrhagic shock.