创伤后心钠素变化与液体治疗的关系  

RELATIONSHIP BETWEEN ATRIAL NATRIURETIC FACTOR (ANF) AND FLUID THERAPY AFTER INJURY

作　　者：朱佩芳[1] 周继红[1] 周元国[1] 刘环林 邹周志 刘大为[1] 徐有奇[2] 袁立功[2] 

机构地区：[1]第三军医大学野战外科研究所,630042 [2]第三军医大学大坪医院

出　　处：《西南国防医药》1993年第3期143-146,191-192,共6页Medical Journal of National Defending Forces in Southwest China

摘　　要：本实验目的是观察烧冲复合伤后液体治疗与心钠素(ANF)、血渗与尿渗变化的关系。实验用狗30只。对照组给液给钠量最少;依次为晶血组;高渗组给钠最多。结果表明,对照组血浆ANF在伤后2、4小时明显减少,8、24小时与伤前差别不明显;其余两组伤后24小时有明显减少,其余时间的ANF值为正常偏低。伤后24小时,心脏ANF对照组明显低于另两组(P<0.01)。对照组血渗偏低,其余两组稍偏高,但与伤前差别不显著。对照组尿渗变化不大,其余两组持续升高,24小时达峰值,尤以高渗组为著。本文对可能影响ANF变化的因子进行了讨论,并提出ANF含量变化与液体治疗时给于的液量和钠量有一定的关系。Thirty dogs were used to study the relationship between fluid therapy and some parameters (ANF,plasma osmotic pressure and urinary osmotic pressure) after burn—blast combined injury. The animals were divided into three groups: the control, isotonic solution plus blood transfusion and hypertonic solution infusion. The smallest amount of sodium was infused in the control group and the largest amount of sodium was infused in the hypertonic group. The results showed that in the control group,the plasma ANF decreased significantly at 2 h and 4 h,but almost normal at 8 h and 24 h after injury. While in the other two groups it was at the lower level of normal limit at 2 h, 4 h and 8 h,but decreased remarkably at 24 h after injury. The ANF level of heart was lower in the control group at 24 h after injury,but much higher in the other two groups. The level of plasma osmotic pressure was lower in the control group and a little higher in the other two groups,but there was no statistical significance in the preinjured values. The urinary osmotic pressure changed insignificantly in the control group, but increased remarkably in the other two groups and reached to the peak(P<0. 01) at 24 h after injury. The increase was more significant in the hypertonic group. The other factors affecting possibly the changes of ANF were discussed in the paper. It was indicated that there was a certain relationship between plasma ANF and the amount of infused fluid and sodium.

关 键 词：冲击伤 烧伤 复合伤 心钠素 液体治疗 渗透压 

分 类 号：R82[医药卫生—临床医学]