家兔吸入性损伤早期应用高氧平衡盐溶液的观察  

The effect of hyperoxic Ringer′s solution on the rabbits with inhalation injury at early postburn stage

作　　者：黄立锋[1] 贾赤宇[1] 谢晓繁[1] 

机构地区：[1]第四军医大学西京医院烧伤科,西安710032

出　　处：《中华烧伤杂志》2005年第3期165-169,共5页Chinese Journal of Burns

基　　金：创伤;烧伤与复合伤国家重点实验室开放课题基金资助项目(2003-1)

摘　　要：目的　探讨高氧平衡盐溶液在家兔吸入性损伤早期的治疗效果及其作用机制。　方法　将77只家兔随机分为4组:正常组(5只),不致伤;平衡盐溶液治疗组(24只),致伤后连续10d补充平衡盐溶液;高氧液治疗组(24只),致伤后连续10d补充高氧平衡盐溶液;对照组(24只),致伤后不治疗。致伤的3组家兔又于伤后1、2、3、5、7、10d6个时相点下观察,每时相点4只。观察各组兔呼吸情况及生存率,检测其动脉血气分析、白细胞及分类、肺湿干重比、肺组织丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性,观察肺组织的病理改变。　结果　各致伤组兔伤后立即出现呼吸频率增快、张口呼吸、鼻翼扇动、咳嗽频繁,口、鼻腔分泌物增多,肺部可闻及干、湿性啰音撕?10d,对照组、平衡盐溶液治疗组、高氧液治疗组兔生存率分别为13. 3%、27. 8%、65. 6%。血气分析结果均显示为代谢性酸中毒。各致伤组各时相点二氧化碳分压、白细胞、中性粒细胞、肺湿干重比、肺组织MDA等指标均较正常组升高,其顺序为:对照组>平衡盐溶液治疗组>高氧液治疗组>正常组;而pH值、氧分压、SOD等指标均较正常组降低,其顺序为:对照组<平衡盐溶液治疗组<高氧液治疗组<正常组(P<0. 05).肺组织病理结果显示,家兔伤后肺体积明显增大,光镜下可见肺组织结构呈炎性改变。Objective To investigate the effect of hyperoxic Ringer′s solution on inhalation injury given at early postburn stage in rabbit. Methods Seventy-seven rabbits were randomly divided into four groups,i.e. A (normal control, n=5, without injury), B (n=24, with Ringer's solution infusion for 10 days after injury), C (n=24, with hyperoxic Ringer′s solution infusion for 10 days after injury) and D (n=24, without treatment after injury) groups. The rabbits in B,C and D groups were observed on 1 post injury day (PID), 2 PID, 3 PID, 5 PID, 7 PID and 10 PID ,with 4 in each time points. The vital signs and survival rate were observed and the blood gas analysis,the WBC and PMN in the peripheral blood,ratio of wet /dry weight(W/D)of the lung tissue,the MDA, SOD contents in the pulmonary tissue, and the pulmonary pathomorphology were determined by corresponding methods. Results The respiratory rate of the rabbits increased postburn, which was accompanied with gasping breath, flapping of nasal alae, frequent cough, and increased buccal and nasal secretion. Dry and wet rales were heard in the lungs after injury. The survival rate in D, B and C groups was 13.3%, 27.8% and 65.6%, respectively. Metabolic acidosis was identified in these groups by blood gas analysis. The indices of PaCO_2, WBC, PMN, W/D, MDA in B,C and D groups were higher than those in A group in the order of D>B>C>A groups. While the pH, PaO_2 value and SOD content in D group were lower than those in A group in the order of D<B <C<A groups (P<0.05). Pathomorphological examination revealed that pulmonary volume increased after the injury with microscopic inflammatory changes in pulmonary tissue in B, C and D groups. While the extent and degree of injury in C group after the treatment of hyperoxic Ringer′s solution were evidently less severe than those in other groups. Conclusion Early administration of hyperoxic Ringer′s solution during the early postburn stage could be beneficial to the management of inhalation injury.

关 键 词：高氧平衡盐溶液 早期应用 吸入性损伤 家兔 超氧化物歧化酶(SOD) 丙二醛(MDA) 动脉血气分析 呼吸频率增快 代谢性酸中毒 二氧化碳分压 治疗组 正常组 高氧液 分泌物增多 中性粒细胞 肺组织结构 吸人性损伤 对照组 作用机制 

分 类 号：R644[医药卫生—外科学] R459.3[医药卫生—临床医学]