论文:经食道超声心动图观察猪空气静脉栓塞的实验研究
经食道超声心动图观察猪空气静脉栓塞的实验研究
上海交通大学附属第六人民医院麻醉科,200233,
王爱忠 周明 张卫兴 赵晶 江伟
【摘要】目的 观察经食道超声心动图(TEE)对空气静脉栓塞的敏感度、空气静脉栓塞典型的TEE表现以及猪空气静脉栓塞的致死量。方法 纯氧机械通气条件下,经猪颈内静脉注入0.1ml空气, 观察TEE的敏感度。每间隔50min,经股静脉分别注入0.05ml/kg、0.1ml/kg、0.25ml/kg、0.5ml/kg、1ml/kg,以后每次增加1 ml/kg,速度为1ml/s,直至猪心跳停止。连续观察TEE图像变化,并记录空气静脉栓塞的致死量。结果 从颈内静脉注入0.1ml空气后,TEE显示右心腔内有强反光点;当从股静脉注射空气后,心腔内亮点逐渐增多,聚合成团状,然后逐渐分散消失。心腔内空气的存留时间随注射空气量的增加而延长。注射2ml/kg的空气后,心腔内空气的存留时间为10-20min。猪死亡时心脏跳动逐渐减慢,心腔内表现为缓慢流动的细沙样物质。其中一头猪注射3ml/kg空气后,左心腔出现很多活动的反光点。猪空气静脉栓塞致死空气量为4?0.9ml/kg。结论 TEE是监测空气静脉栓塞敏感的方法; 心腔内空气的存留时间随注射空气量的增加而延长;猪的空气静脉栓塞的致死量为4?0.9ml/kg。
【关键词】经食道超声心动图; 空气栓塞
The experimental study of transesophageal echocardiography
monitoring for detection of venous air embolism in pigs Wang
Ai-zhong,Zhou Ming,Zhang Wei-xing,et al.Department of
Anethesiology,Shanghai Sixth People’s Hospital,Shanghai
Jiaotong University,Shanghai 200233,China
【Abstract】Objective To observe the sensitivity and classic illustration of transesophageal echocardiography(TEE) for detection of venous air embolism.Furthermore ,to obtain lethal dose of venous air in pigs.Methods Six pigs were mechanically ventilated with 100% oxygen after they were anesthetized. 0.1ml air was injected via the internal jugular vein in order to observe the sensitivity of TEE. 0.05ml/kg、
0.1ml/kg、0.25ml/kg、0.5ml/kg and 1ml/kg air were injected via the femoral vein at a rate of 1ml/s at the interval of 50min between two injectios.Then the dose of air was added 1ml/kg at each injection until the pig died.These pigs were continuously monitored with TEE.. Lethal dose of venous air in each animal was recorded.. Result Several particles were found in right heart after 0.1ml air was injected via the internal jugular vein. when over 0.1ml/kg air was injected via femoral vein ,TEE showed that a lot of particles appeared immediately in right heart, then these particles aggregated and gradually dispeared. The air exsitance time (AET)in
heart was longer when larger volume air was injected.After 2ml/kg air was injected, AET was 10-20min。when pis were going
to die, TEE showed that there were fine particles that slowly flowed in the hearts. when 3ml/kg air was injected ,air was found in the left heart in One of six pigs The lethal dose of venous air was 4?0.9ml/kg .Conclusion TEE is a sensitive
method for detection of air venous embolism; AET was longer when larger volume air was injected; The lethal dose of venous air is 4?0.9ml/kg.
【Key words】 Transesophageal echocardiography; Air
embolism