犬烧伤后早期延迟快速复苏对肝功能的影响  

Effect of delayed rapid fluid resuscitation on liver function in early stage postburn

作　　者：柏刚 杨宗城[1] 黄跃生[1] 刘志远[1] 傅琼芳[1] 何保斌[1] 黎鳌[1] 

机构地区：[1]第三军医大学西南医院烧伤研究所

出　　处：《世界华人消化杂志》1999年第7期573-575,共3页World Chinese Journal of Digestology

摘　　要：目的探讨烧伤后延迟复苏情况下，快速补液对伤后早期肝脏功能的影响．方法利用犬４０％ＴＢＳＡⅢ度烫伤模型，３２只狗被随机分为烧伤对照组、血定安延迟均匀补液组、血定安延迟快速补液组和血浆延迟快速补液组进行补液，观察伤前、伤后２，６，８，１２，２４，３６和４８ｈ血清蛋白、肝酶学和肿瘤坏死因子等指标的变化．结果烧伤后各组血清ＡＬＴ，ＡＬＰ和ＴＮＦ逐渐升高，至伤后２ｈ～６ｈ即显著高于伤前并继续升高，但补液三组上升幅度明显低于烧伤对照组，其中快速补液组烧伤８ｈ后（快速补液后）均显著低于均匀补液组．伤后各组血清总蛋白、清蛋白逐渐降低，至伤后２ｈ显著低于伤前并继续降低，快速补液组伤后８ｈ（快速补液后）ＴＰ，Ａｌｂ均显著低于均匀补液组，以后逐渐升高，至伤后３６ｈ显著高于均匀补液组．血浆与血定安快速组相比，ＡＬＴ，ＡＬＰ和ＴＮＦ几乎无显著差别，而ＴＰ，Ａｌｂ补液后血浆组即显著高于血定安组．结论在烧伤后延迟复苏情况下，快速补液可以减轻肝功能的损害．AIM To investigate the effect of rapid fluid replacement on liver function in delayed resuscitation after burn. METHODS The dogs inflicted with 40% TBSA degree scalding and were randomly divided into 4 groups: burn control group (C group), delayed homogeneous Gelofusin replacement group (H group), delayed rapid Gelofusin replacement group (R group) and delayed rapid plasma replacement group (P group). The serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), total protein (TP), albumin(Alb) and tumor necrosis factor (TNF) were detected at preburn, 2, 6, 8, 12, 24, 36 and 48 hours postburn. RESULTS Serum ALT, ALP and TNF were markedly increased 2-6 hours postburn, but the parameters of R, H and P groups were obviously lower than that in C group after fluid resuscitation, and the parameters of R group were obviously lower than that in H group 8 hours postburn (after rapid fluid replacement). The TP and Alb of each group were markedly decreased 2 hours postburn, although the parameters of R group were obviously lower than that in H group, but they were higher than that in H group 36 hours postburn. There were no significant differences between ALT, ALP and TNF of R and P group, but the TP and Alb of P group were markedly higher than that in R group after fluid replacement. CONCLUSION In delayed resuscitation after burn, rapid fluid replacement can protect liver function.

关 键 词：烧伤 休克 延迟复苏 快速补液 肝功能 

分 类 号：R575.3[医药卫生—消化系统] R644.06[医药卫生—内科学]