卡巴胆碱对烧伤休克犬口服补液时胃肠功能和循环指标的影响  

Effect of carbachol on gastrointestinal function and hemodynamic parameters in resuscitation of burn shock with oral rehydration solution in dogs

作　　者：林凯[1] 车晋伟[2] 任青华[2] 黎君友[2] 马诺山[2] 胡森[2] 盛志勇[2] 

机构地区：[1]空军总医院临床检验中心,北京100037 [2]解放军总医院第一附属医院全军烧伤研究所休克与多器官功能障碍实验室,北京100037

出　　处：《感染．炎症．修复》2008年第1期9-12,共4页Infection Inflammation Repair

基　　金：军队医药卫生"十一五"专项课题(06Z055)

摘　　要：目的:研究拟胆碱药卡巴胆碱对烧伤休克口服补液犬血循环指标和胃肠功能的影响。方法:健康雄性杂种犬24只,采用凝固汽油燃烧法制成30%TBSAⅢ度烧伤模型。随机分为不补液(NR)组、口服葡萄糖-电解质溶液(ORS液)组和口服葡萄糖电解质液+卡巴胆碱(ORS/CAR)组,分别于伤前和伤后3、6、9、24、48h测定平均动脉压(MAP)、胃黏膜内pH值(pHi)、肠腔内压力(IP)、血浆D-乳酸含量、血浆二胺氧化酶(DAO)活性及24、48 h尿量等指标,同时记录伤后呕吐量。结果:烧伤后ORS组和ORS/CAR组犬MAP及48 h尿量在各时间点差异均无显著性(P均>0.05),但均高于NR组(P均<0.05);烧伤后NR组胃pHi低于两补液组(P<0.05),并且ORS组胃phi低于ORS/CAR组(P<0.05);烧伤后各组IP、DAO和D-乳酸均升高,其中ORS组IP和DAO始终高于ORS/CAR组(P<0.05);ORS组D-乳酸仅在伤后48h与ORS/CAR组有差异(P<0.05)。结论:卡巴胆碱能显著改善烧伤休克口服补液时的胃肠功能和循环指标,提高烧伤休克口服液体复苏的疗效。Objective：To investigate the effect of carbachol on gastrointestinal function and hemodynamic param- eters in resuscitation of burn shock with oral rehydration solution.Methods：Twenty-four healthy male dogs with 30% TBSAⅢdegree burn injury were divided into three groups：burns without resuscitation（NR）,burns trea- ted with oral rehydration solution alone（ORS）and burns treated with oral rehydration solution plus carbachol （ORS/CAR）.Mean arterial pressure（MAP）,24-and 48-hour urinary output,gastric intramueosa p H（pHi）,in testinal pressure（IP）,plasma diamine oxidase（DAO）and D-lactic acid were determined at 0,3,6,9,24 and 48 hours postburn.Total vomiting volume was recorded at the same time.Results：MAP and 48-urinary output in ORS and ORS/CAR group were higher than NR group（all P〈0.05）after burns,and there was no significant differences between ORS and ORS/CAR groups（P）0.05）.Gastric phi in ORS/CAR and ORS group was signifi cantly higher than that in NR group postburn（P〈0.05）,and gastric pHi in ORS/CAR group was higher than in ORS groups（P〈0.05）.Plasma DAO and IP levels were significantly increased in all groups after burns,and they were significantly higher in ORS group than in ORS/CAR group at all time points（P〈0.05）.Plasma D-lactic level in ORS group was higher than that of ORS/CAR group at 48 hours postburn（P〈0.05）.Total vomiting vol ume in ORS group was significantly larger than that in other groups（P〈0.05）,while there was not much differ ence between NR and ORS/CAR groups（P〉0.05）.Conclusion：The results suggest that carbachol has a notable effect on improving gastrointestinal function and hemodynamic parameters in the resuscitation of burns shock with oral rehydration solution.

关 键 词：烧伤 休克 口服液 胃肠道 卡巴胆碱 

分 类 号：R512.5[医药卫生—内科学] R644[医药卫生—临床医学]