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犬在止血带休克期间肾皮质出现片状、间歇性缺血。

Patchy, intermittent ischemia in renal cortex during tourniquet shock in dog.

作者信息

Tyssebotn I, Kirkebø A

出版信息

Acta Physiol Scand. 1980 Jul;109(3):253-60. doi: 10.1111/j.1748-1716.1980.tb06595.x.

Abstract

UNLABELLED

The effect of bilateral hindlimb occlusion on the distribution of renal cortical blood flow was investigated in anesthetized dogs. Local blood flow in outer cortex (OCF) and in inner cortex (ICF) was measured by 6 platinum electrodes recording hydrogen gas clearance. Renal blood flow fell unsignificantly while hematocrit (Hct) rose from 37 to 47% during the 4 h tourniquet period. After the release of the tourniquets average arterial blood pressure fell to about 75% of control, whereas OCF and ICF were proportionately reduced towards 30--40% of control. Hct increased to 58%. Patchy, intermittent ischemia in outer and inner cortex was irregularly observed after release of the tourniquets when Hct had increased markedly, as previously found during dehydration and endotoxin shock. The sudden shifts in washouts rates from single electrodes were not accompanied by corresponding variations in total renal blood flow. Heparinization of alpha-receptor blocking did not suppress the appearance of abrupt flow changes in this period. However, sudden shifts in local flow were also seen shortly after application of the tourniquets, before Hct had increased, in this phase possibly induced by an increased renal nervous tone.

IN CONCLUSION

OCF and ICF fell to the same degree during tourniquet shock. Patchy, intermittent ischemia was observed in the renal cortex, most frequently at high Hct, but also before Hct did rise.

摘要

未标记

在麻醉犬中研究了双侧后肢阻断对肾皮质血流分布的影响。通过6个铂电极记录氢气清除率来测量外皮质(OCF)和内皮质(ICF)的局部血流。在4小时的止血带阻断期间,肾血流量无明显下降,而血细胞比容(Hct)从37%升至47%。松开止血带后,平均动脉血压降至对照值的约75%,而OCF和ICF相应地降至对照值的30%-40%。Hct升至58%。如先前在脱水和内毒素休克期间所发现的,当Hct显著升高后松开止血带时,在外皮质和内皮质中不规则地观察到散在的、间歇性缺血。单个电极冲洗率的突然变化并未伴随肾总血流量的相应变化。α受体阻断的肝素化并未抑制此期间突然血流变化的出现。然而,在应用止血带后不久,在Hct升高之前,也观察到局部血流的突然变化,此阶段可能由肾神经张力增加所致。

结论

在止血带休克期间,OCF和ICF下降程度相同。在肾皮质中观察到散在的、间歇性缺血,最常见于高Hct时,但也在Hct升高之前出现。

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