小型猪严重烧伤后超早期切痂对血液流变学的影响  

Effect of super early escharectomy on the hemorheology of mini pigs after severe burn

作　　者：刘军[1] 徐刚[1] 段晨旺[1] 李凤山[1] 陈树强[1] 冯玉柱[1] 刘冬梅[1] 杜秀红[1] 

机构地区：[1]唐山工人医院烧伤整形科,河北省唐山市063000

出　　处：《中国临床康复》2004年第29期6382-6383,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨小型猪严重烧伤后6h内切痂即超早期切痂的可行性,以()利于严重烧伤创面的早期修复。方法:选择中国实验用小型猪制作严重烧伤动物模型,随机分为实验组和对照组。分别于伤前、伤后,,,,和6816244872h检测血流动力学指标(心排出量,右心房压)及血液流变学指标(低切变全血黏度和红细胞聚集指数)。结果:血流动力学变化:两组动物心排出量和右心房压伤后均很快下降,实验组于伤后8h心排出量和右心房压开始恢复,至伤后48h已基本恢复正常。对照组心排出量持续下降,伤后48h恢复至伤前水平,此后仍继续升高。对照组右心房压伤后8h降至最低点,至伤后72h恢复正常。血液流变学变化:统计学处理显示两组低切变全血黏度和红细胞聚集指数间差异无显著性意义。结论:超早期切痂可使小型猪在围手术期内血流动力学更加平稳,对血液流变学亦无不良影响。从动物实验角度来看,超早期切痂是可行的。对大面积烧伤创面早期修复及临床治愈率提高有重要的指导意义。AIM: To investigate the feasibility of escharectomy in mini pigs within 6 hours after severe burn(super early escharectomy), so as to benefit to the early rehabilitation for severe burn wound. METHODS: Chinese experimental mini pigs were selected to establish the badly burn animal models, and were randomly divided into two groups: experimental group and control group. The hemodynamics indexes[cardiac output(CO) and right atrial pressure(RAP)] and hemorheology indexes(the low shear viscosity of whole blood and the erythrocytic aggregation index) were detected before and 6, 8, 16, 24, 48 and 72 hours after burn. RESULTS: The changes of hemodynamics: The CO and RAP of both groups dropped rapidly after burn.The CO and RAP of the experimental group began to recover at 8 hours after burn and returned to the normal level at 48 hours after burn.The CO of the control group kept dropping continuously, and then regained to the level of preinjury at 48 hours after burn, and then it still kept rising. The RAP of the control group decreased to the lowest point at 8 hours after burn, and then came to the normal level at 72 hours after burn. The changes of hemorheology: The statistical process indicated that there was no significant difference in the low shear viscosity of whole blood and the erythrocytic aggregation index between the two groups. CONCLUSION: The super early escharectomy will provide a more steady hemodynamics in perioperative stage and it has no harm to hemorheology. From the view of the animal experiment,the super early escharectomy is feasible. It has an important significance on the early rehabilitation of burn wound with a large area and the promotion of clinical healing rate.

关 键 词：严重烧伤 切痂 超早期 右心房 心排出量 小型猪 对照组 内切 最低点 结论 

分 类 号：R644[医药卫生—外科学] R743[医药卫生—临床医学]