卡巴胆碱对烧伤休克口服补液时肠屏障功能的影响  

Effect of carbachol on gut barrier function in resuscitation of burn shock with oral rehydration

作　　者：杜颖[1] 胡森[1] 韩伊林[2] 车晋伟[1] 张建举 耿世佳[1] 王国强[1] 吴静[1] 田易军[1] 黎君友[1] 

机构地区：[1]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障碍实验室,北京100037 [2]内蒙古医学院,呼和浩特010059 [3]内蒙古第二医,呼和浩特010059

出　　处：《中国急救医学》2008年第3期239-242,共4页Chinese Journal of Critical Care Medicine

基　　金：军队医药卫生“十一五”科研基金资助项目(No06Z055)

摘　　要：目的研究拟胆碱药卡巴胆碱对犬烧伤休克口服补液时肠屏障功能的影响。方法成年雄性Beagle犬20只,采用凝固汽油燃烧法造成35% TBSAⅢ度烧伤,烧伤后随机分为延迟复苏(DR)组、口服葡萄糖-电解质溶液(GES)组、口服卡巴胆碱(CAL)组、口服葡萄糖-电解质溶液+卡巴胆碱(GES+CAL)组。GES按Parkland公式(4mL·kg-1.1% TBSA-1)经胃管输注,卡巴胆碱20μg/kg溶于10mL生理盐水中,分别于伤后30min和4h经胃管注入。烧伤24h后各组均给予静脉输注5%葡萄糖生理盐水液进行延迟复苏。测定各组动物伤前及伤后2、4、8、24、48、72h血浆二胺氧化酶(DAO)活性、D-乳酸(D-LA)含量和D-木糖(D-XY)含量。结果烧伤后DR组血浆DAO、D-LA和D-XY显著高于另外三组(P<0.01,P<0.05)。各治疗组间比较,GES+CAL组血浆DAO伤后2h和4h显著低于GES组和CAL组(P<0.05),GES+CAL组D-XY伤后8h和24h显著低于GES组和CAL组(P<0.05)。结论卡巴胆碱对犬烧伤休克口服补液时肠屏障功能有保护作用。Objective To investigate the effect of carbachol on gut barrier function in the resusci- tation of burn shock with oral rehydration in dog. Methods 20 adult male Beagle dogs with 35% TBSA Ⅲ ° burn by napalm combustion method were randomly divided into delayed resuscitation （ DR ） group, peroral glucose electrolyte solution （GES） group,peroral carbachol （CAL） group, and peroral GES plus carbachol（ GES ＋ CAL） group. According to Parkland formula（4 mL · kg^-1 · 1% TBSA^-1 ）, GES was given oral by a gastric tube. Carbachol （20 ·g/kg） was dissolved normal sodium and took orally by a gastric tube at 30min and 4 h post burn. Four groups likewise treat with delayed venous - fluid resuscitation with 5% glucose in normal saline after 24 h post burn. blood diamine oxidase （DAO）,D -lactic acid （ D - LA） and D - xylems （ D - XY） of each animal were detected at preinjury and 2,4,8,24,48,72 hours post burn. Result Levels of blood DAO, D - LA and D - XY of DR group were significantly higher comparing with other three groups （ P 〈 0. 01 ＆ P 〈 0. 05 ）. Group comparison of each treatment, blood DAO in GES ＋ CAL group was lower than GES group and CAL group in 2 h and 4 h post bum. In 8 h and 24 h post burn, level of blood D - XY in GES/CAL group was lower than GES group and CAL group （ P 〈 0. 05 ）. Conclusion It is indicated that carbachol have effect on protecting gut barrier function in the resuscitation of burn shock with oral rehydration in dog.

关 键 词：烧伤 休克 肠屏障 口服溶液 卡巴胆碱 

分 类 号：R644[医药卫生—外科学]