摘要目的 评价不同浓度碘伏腹腔冲洗术对兔血流动力学及酸碱平衡的影响.方法 清洁级健康成年雄性新西兰大白兔24只,3月龄,体重2.8～3.2 kg,采用随机数字表法分为4组(n=6):对照组(C组)、碘伏1/3原浓度组(TI组)、碘伏1/2原浓度组(HI组)和碘伏原浓度组(OI组).腹腔注射3％戊巴比妥1.5 ml/kg麻醉兔,局麻下行左股动脉置管监测有创BP,行腹腔切开.开腹后10 min时C组、TI组、HI组和OI组分别采用生理盐水、碘伏与生理盐水1∶2稀释溶液、碘伏与生理盐水1∶1稀释溶液和碘伏原液20 ml冲洗腹腔,冲洗液腹腔留置2 min后无菌纱布蘸干后关腹.于冲洗前即刻(T0)、冲洗结束后5、10、20 min、1和2 h(T1-5)时记录MAP和HR,于T0、4、5时采集股动脉血行血气分析,记录pH值、BE和乳酸水平.记录腹腔冲洗前麻醉持续时间,麻醉后2h累积麻醉用药量、补液量和尿量,记录腹腔冲洗后3h兔死亡情况.结果 与C组比较,TI组、HI组和0I组T1-5时MAP、T3-5时HR、HI组和OI组T4、5时pH值降低,BE负值升高,OI组T5时乳酸水平、HI组和OI组兔死亡率升高(P＜0.05);与TI组比较,OI组T4、5时MAP、T5时pH值降低,BE负值升高,T4,5时乳酸水平、HI组和OI组兔死亡率升高(P＜0.05);与HI组比较,OI组各指标差异无统计学意义(P＞0.05).结论 碘伏腹腔冲洗术可呈浓度依赖性致兔血流动力学恶化,酸碱平衡失调.

abstractsObjective To evaluate the influence of peritoneal lavage with different concentrations of povidone-iodine on hemodynamics and acid-base balance in rabbits.Methods Twenty-four clean-grade healthy adult male New Zealand white rabbits,aged 3 months,weighing 2.8-3.2 kg,were divided into 4 groups (n=6 each) using a random number table:control group (group C),povidone-iodine 1/3 of original concentration group (group TI),povidone-iodine l/2 of original concentration group (group HI) and povidone-iodine of original concentration group (group OI).Rabbits were anaesthetized with intraperitoneal 3％ pentobarbital 1.5 ml/kg,the left femoral artery was cannulated for invasive blood pressure monitoring,and the abdominal cavity was opened.Peritoneal lavage was performed with normal saline,povidone-iodine diluted with normal saline (1 ∶ 2),povidone-iodine diluted with normal saline (1 ∶ 1) and original povidone-iodine 20 ml at 10 min after opening abdominal cavity in C,TI,HI and OI groups,respectively.The fluid for peritoneal lavage was sucked out using a sterile gauze 2 min later and then the abdominal cavity was closed.Mean arterial pressure (MAP) and heart rate (HR) were recorded immediately before lavage (T0) and at 5,10 and 20 min and 1 and 2 h after the end of lavage (T1-5).Arterial blood samples were collected at T0,T4 and T5 for blood gas analysis,and the pH value,BE and lactic acid level were recorded.The duration of anesthesia before peritoneal lavage,cumulative dose of anesthetics,fluid volume and urine volume at 2 h after anesthesia,and mortality at 3 h after peritoneal lavage were recorded.Results Compared with group C,MAP at T1-5 and HR at T3-5 were significantly decreased in TI,HI and OI groups,pH value was significantly decreased and BE negative value was increased at T4,5 in HI and OI groups,the lactic acid level was significantly increased at T5 in group OI,and the mortality rate were significantly increased in HI and OI groups (P＜0.05).Compared with group TI,MAP at T4,5 and pH value at T5 were significantly decreased,BE negative value was increased at T5,and the lactic acid level was increased at T4,5 in group Ol (P＜0.05).There was no significant difference in each parameter between group OI and group HI (P＞0.05).Conclusion Peritoneal lavage with povidone-iodine dose-dependently leads to hemodynamic deterioration and acid-base imbalance in rabbits.