小型猪重度烧伤休克稳定模型的制作  

Shock modeling of large area third-degree burn in miniature swine

作　　者：邢楠[1] 周建军[1] 陈炯[1] 苏国良[1] 施剑武[1] 池章章[1] 

机构地区：[1]温州医学院附属第三医院瑞安市烧伤研究所,浙江省瑞安市325200

出　　处：《中华医学杂志》2013年第10期785-788,共4页National Medical Journal of China

基　　金：浙江省科技计划（2010C33009）

摘　　要：目的制作小型猪重度烧伤休克的稳定模型。方法按随机数字表法将12只4-6月龄雌性广西巴马小型猪分为A、B两组各6只，静脉麻醉等处理后，以凝固汽油燃烧制作占体表总面积（TBSA）40％的皮肤烧伤（A组45s，B组50s），肉眼与组织病理学检查判断创面深度；在烧伤后2h进行复苏，记录每小时心率、血压、尿量、中心静脉压（CVP）、肺动脉契压（PAWP）及烧伤前和烧伤后第1、2个24h液体实际输入量，根据伤后2h的休克指数判断休克状态。结果A、B两组均完成烧伤模型制作，烧伤创面分别呈深Ⅱ、Ⅲ度改变。烧伤后2h与烧伤前比较，两组猪均呈现心率加快[（111±6）比（74±9）、（119±13）比（75±13）次／min]、尿量减少[（0．99±0．06）比（1．45±0．05）、（0．82±0．04）比（1．47±0．06）ml．kg-1·h-1]、CVP与PAWP下降，差异均有统计学意义（均P〈0．05）；而血压无显著变化[（120±6／93±9）比（120±6／94±6）、（121±15／90±11）比（124±10／91±8）mmHg]，差异均无统计学意义（均P〉0．05）；烧伤后48h内血压均值组间差异均无统计学意义（均P〉0．05）。A、B组烧伤后第1个24h复苏液体量分别为（1．53±0．05）、（1．66±0．10）ml·kg-1·1%-1 TBSA，差异有统计学意义（P〈0．05），两组液体进出量比值差异均无统计学意义（P〉0．05）；烧伤后第2个24h的复苏液体量分别为（0．65±0．16）、（0．69±0．17）ml·kg-1·1％-1TBSA，差异无统计学意义（P〉0．05），液体进出量比值差异无统计学意义（P〉0．05）。A、B组在2h时相点的休克指数分别为0．92±0．07、1．00±0．16，差异无统计学意义（P〉0．05）。结论本法制作的小型猪重度烧伤休克的模型稳定可靠。Objective To report a novel method of establishing a stable shock model of swine. Methods A total of 12 Guangxi BA-MA female miniature swines （ aged 4 -6 mouths） into A and B groups according to a random number table. Total body surface area （TBSA） was calculated according to the Meeb-Rubner formula. After intravenous anesthesia and other steps, solidified gasoline was used as burns material to establish TBSA 40% skin burn （Group A： 45 s, Group B： 50 s）. Burn depth by was judged by visual and histopathological examination. Fluid resuscitation was instituted at 2 h post injury. At the same time, the hourly and pre-injury data of heart rate （ HR）, blood pressure （ BP）, urinary volume, central venous pressure （CVP） and pulmonary arterial wedge pressure （PAWP） were recorded. The actual input quantities of fluid resuscitation were assessed at the 1st and 2nd 24 h post injury. And shock condition was estimated by shock index at 2 h post injury. Results All miniature swines were successfully modeled without any mortality. The burn wound observed by visual examination and light microscope showed that Group A was of deep Ⅱ burn and Group BⅢI burn. Compared with the pre-injury data, HR （ 111 ±6 vs 74 ± 9, 119 ± 13 vs 75 ± 13 beats/min） increased, urinary volume （0. 99 ± 0. 06 vs 1.45 ± 0. 05, 0. 82 ± 0. 04 vs 1.47 ±0. 06 ml . kg-1. h-1）, CVP and PAWP decreased at 2nd 24 h post-injury in two groups （P 〈 0.01, P〈0.05）. But the changes of BP （120±6/93±9 vs 120±6/94±6, 121±15/90±11 vs 124± 10/91 ± 8 mm Hg） had no statistical significance （P 〉 0. 05 ）. The average value of HP in 48 h post-injury had no statistical significance in two groups （ P 〉 0. 05 ）. The recovery liquid quantity in the first 24 h of Group B （1.66 ±0. 10 ml .kg-1 . 1% -1 TBSA） was significantly more than Group A （1.53 ±0. 05 ml .kg-1. 1% -1TBSA） （P 〈0. 05）. The ratio between liquid input and output of Groups A and B showed that the comparison had no statistic

关 键 词：烧伤 休克 模型 动物 猪 雏型 

分 类 号：R644[医药卫生—外科学]