采用核素法研究犬烧伤休克口服补液时胃排空率的变化  

Study on the rate of gastric emptying with emission scanning tomography in oral resuscitation of burn shock in dogs

作　　者：段中响[1] 欧阳巧洪[1] 胡泉[2] 沈小鹏[2] 

机构地区：[1]解放军总医院第一附属医院核医学科,北京100048 [2]解放军总医院第一附属医院烧伤科,北京100048

出　　处：《感染．炎症．修复》2011年第2期98-100,I0002,共4页Infection Inflammation Repair

摘　　要：目的:研究犬烧伤前后胃排空的变化,为临床烧伤休克口服补液复苏提供实验依据。方法:采用成年雄性Beagle犬18只,均用凝固汽油造成背部及四肢35%TBSAⅢ度烧伤,随机分为高渗液组和莫沙比利组,分别于烧伤前禁食水8 h后及烧伤后经胃管给予高渗葡萄糖液2 ml·kg^(-1)·1%TBSA^(-1)或高渗葡萄糖液+莫沙比利0.25 mg·kg^(-1)·h^(-1),同时经胃管注入放射性核素锝标记的二乙烯三胺五乙酸(^(99m)Tc-DTPA),采用ECT测定胃内残余放射性活度计算胃排空率和50%胃排空时间。结果:烧伤前,莫沙比利组胃排空率明显高于高渗液组(P<0.01),烧伤后高渗液组胃排空速率明显低于本组烧伤前和莫沙比利组(P<0.01),莫沙比利组的胃排空率烧伤前后差异无显著性(P>0.05)。高渗液组伤后50%胃排空时间较伤前明显延长(P<0.01),莫沙比利组伤后较伤前明显加快(P<0.01),且莫沙比利组伤前和伤后50%胃排空时间均明显少于高渗液组的相应时间(P<0.01)。结论:35%TBSAⅢ度烧伤后胃排空速率显著降低,莫沙比利可以加速胃排空。Objective： To study the changes in the gastric emptying of dogs before and after burn, in order to provide the experimental basis for oral resuscitation of burn shock. Methods：Eighteen male Beagle dogs with 35% TBSA full-thickness degree burn in the back and limbs were randomly divided into two groups： hypertonic electrolyte glucose solution group （HEGS group） and Mosapride ＋ hypertonic electrolyte glucose solution group （MHEGS group）. Gastric emptying rate of each group was measured before and after burn injury. In the HEGS group,2 ml ·kg^-1·1 %TBSA 1 of hypertonic electrolyte-glucose solution and ^99mTc-DTPA were gavaged through stomach-tube after burn injury （fast for 8 hours before burn）. In the MHEGS group, hypertonic electrolyte-glucose solution and Mosapride （0.25 mg ·kg^-1· h^-1 ） were gavaged instead of hypertonic electrolyte-glucose solution alone. Gastric emptying rate and 50% gastric emptying time of the two groups were measured by detecting the radioactivity of intragastric ^99mTc-DTPA with emission scanning tomography （ECT）. Results： Gastric emptying rate of MHEGS group was obviously higher than that of HEGS group before burn injury （P〈0.01）. After burn injury gastric emptying time was obviously lower in HEGS group than that of before injury and also MHEGS group after injury （P〈0. 01）. In the MHEGS group, gastric emptying rate after burn was similar to that before burn injury （P〉0.05）. The 50% gastric emptying time was prolonged after burn in HEGS group （P〈0.01）, but it was shorter in MHEGS group after burn （P〈0.01）. Conclusion：The gastric emptying rate is obviously prolonged after 35 %TBSA full-thickness burn injury, and the administration of Mosapride can expedite gastric emptying.

关 键 词：烧伤 液体复苏 高渗葡萄糖液 莫沙比利 胃排空 

分 类 号：R644[医药卫生—外科学]