再论烧伤后“休克心”及其临床意义  

Further discussion on postburn ＂shock heart ＂ and its clinical significance

作　　者：黄跃生[1] 

机构地区：[1]第三军医大学西南医院全军烧伤研究所,创伤、烧伤与复合伤国家重点实验室,重庆400038

出　　处：《中华烧伤杂志》2009年第3期161-163,共3页Chinese Journal of Burns

摘　　要：烧伤后早期缺血缺氧损害难以避免，是引起严重烧伤并发症和死亡的最重要原因。早在20世纪60年代，人们已发现严重烧伤休克期心功能减退的现象。20世纪80年代以前，人们将其归咎于烧伤后毛细血管通透性增加使血容量显著减少，导致回心血量减少；以后则认为还与心肌抑制因子等的作用有关。A series of studies demonstrated that myocardial damage and cardiac dysfunction occur immediately after severe burn even before the intervention of significant reduction in blood volume as a result of increased capillary permeability. Because the heart is the power organ of the circulation, such myocardial damage and cardiac dysfunction lead not only to cardiac deficiency, it is also a precipitating factor of burn shock and ischemic/hypoxic injury. Therefore, we nominate this phenomenon as ＂ shock heart＂. New measures including ＂ volume replacement＂ plus ＂ dynamic support＂ proposed according to this new recognition is of important clinical significance for burn shock resuscitation and prevention and treatment of ischemic/hypoxic injury, as well as reducing organ complications resulting from insufficient or excessive fluid resuscitation during early postburn stage.

关 键 词：烧伤 休克心 缺血缺氧 防治 

分 类 号：R644[医药卫生—外科学] R285.5[医药卫生—临床医学]