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麻醉马的模拟小肠扭转

Simulated small intestinal volvulus in the anesthetized horse.

作者信息

Hjortkjaer R K, Svendsen C K

出版信息

Nord Vet Med. 1979 Nov;31(11):466-83.

PMID:523313
Abstract

Experimental closed loop small intestinal volvulus was studied in the anesthetized horse. Volvulus was simulated by ligation of the mesenterial veins to a segment of small intestine. Physical signs and hemodynamic, hematologic, clinical chemical, bacteriologic and peritoneal fluid values were examined. Compared to conscious horses anesthesia highly delayed and modified the clinical signs of shock (changes in mucosal colour, dehydration, decreased skin temperature, elevated pulse rate, low blood pressures) and of small intestinal volvulus (altered peristalsis, gastric dilation). Plasma glucose response to shock was also modified by unconsciousness. However, a dose response relationship was indicated between the extent of small intestinal damage and clinical symptoms. The same was applicable to changes in blood pressures, blood acid-base balance, lactate, potassium, chloride, glucose, inorganic phosphorus, creatinine, creatine kinase, red blood cell and total white blood cell counts and serum total protein. The relationship was also indicated in the following peritoneal fluid values: volume, lactate, pH, total white cell counts, alkaline phosphatase and bacteriology. Changes related to shock (insufficient tissue perfusion) were low blood pressures and metabolic acidosis due to anaerobic glycolysis with accumulation of lactic acid. Also low plasma glucose and elevated plasma potassium, creatinine, inorganic phosphorus and creatine kinase were regarded as consequences of shock.

摘要

在麻醉的马身上研究了实验性闭环小肠扭转。通过将肠系膜静脉结扎到一段小肠来模拟扭转。检查了体征、血流动力学、血液学、临床化学、细菌学和腹腔液值。与清醒的马相比,麻醉极大地延迟并改变了休克的临床体征(黏膜颜色改变、脱水、皮肤温度降低、脉搏率升高、血压降低)和小肠扭转的体征(蠕动改变、胃扩张)。意识丧失也改变了血浆葡萄糖对休克的反应。然而,小肠损伤程度与临床症状之间存在剂量反应关系。血压、血液酸碱平衡、乳酸、钾、氯、葡萄糖、无机磷、肌酐、肌酸激酶、红细胞和白细胞总数以及血清总蛋白的变化也适用这一关系。以下腹腔液值也显示了这种关系:体积、乳酸、pH值、白细胞总数、碱性磷酸酶和细菌学。与休克相关的变化(组织灌注不足)是由于无氧糖酵解和乳酸积累导致的低血压和代谢性酸中毒。血浆葡萄糖降低以及血浆钾、肌酐、无机磷和肌酸激酶升高也被视为休克的后果。

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