犬烧伤休克延迟复苏的实验研究  

An experimental study on the delayed resuscitation of dogs wi th burn shock

作　　者：王德伟[1] 朱世辉[2] 刘世康[2] 葛绳德[2] 

机构地区：[1]连云港市第一人民医院烧伤科,222002 [2]第二军医大学长海医院烧伤科

出　　处：《中华烧伤杂志》2001年第5期269-271,共3页Chinese Journal of Burns

摘　　要：目的　探讨应用林格液进行烧伤休克延迟复苏的效果。　方法　 12只犬随机分为对照组 (S组 ,6只 )和治疗组 (LR组 ,6只 )。LR组采用 35 %TBSAⅢ度烧伤模型 ,伤后 6h以乳酸林格液进行复苏 ,并以尿量为 1 0ml·kg-1·h-1及心输出量为伤前值的 70 %～ 80 %来调整输液速度及输入量 ,观察其在伤后第一个 2 4h复苏中的容量负荷、平均动脉压 (MAP)、左心室收缩压 (LVSP)、左室内压最大上升 /下降速率 (±dp/dtmax)、心脏排血指数 (CI)、氧供给 (DO2 )及氧消耗 (VO2 )等的变化。　结果　乳酸林格液在烧伤休克延迟复苏后第一个 2 4h的复苏中 ,每 1%烧伤面积的输液量为 (8 87± 1 0 2 )ml/kg ,比采用Parkland公式复苏多 1 2倍 ,其中在复苏后 4h内的输液量为 (3 6 3± 0 99)ml/kg ,为总入量的 41%;MAP、LVSP、±dp/dtmax、CI、DO2 及VO2 等指标在复苏后 2h即达到或接近对照组水平。　结论　乳酸林格液在烧伤休克延迟复苏中 ,比早期复苏需要更多的液体量才能满足需求 ,而血流动力学、心肌功能及氧动力学等在复苏后 2h即有明显改善。Objective To explore the effe cts of delayed resuscitation on burn shock with ringer′s solution. Methods Twelve mongrel dogs were randomly divided into control (S,n=6) and treatment(LR,n=6) groups.The dogs in LR group were inflicted by 35%T BSA III degree burn and were resuscitated with Lactate Ringer′s solution.Urine output in amount of 1 ml·kg -1 ·h -1 ,and cardiac output at level of 7 0%～80% of pre-burn level were referred for the modulation of the speed and am o unt of fluid infusion.The postburn changes of volumetric load,mean arterial pres sure(MAP),LVSP ±dp/dtmax,CI,DO 2 and VO 2 during the first 24 hours of resusc itation were observed. Results The infusion amount of LR solution was 8.87±1.02 ml/k g per 1%TBSA during the first 24 hours of resuscitation,which was 1.2 times more than that with Parkland formula.Furthermore,the infusion fluid amount within th e first 4 hours of resuscitation was (3.63±0.99)ml·kg -1 ·1%TBSA -1 , which was 41% of total amount within the first 24 hours.MAP,LVSP,± dp/dtmax,CI,DO 2 and VO 2 reached or approached the levels in S group within 2 hours of resuscitation.ConclusionThe infusion amount of Lactate Ringer′s solution needed in delayed resuscitation was larger than that in early re suscitation.And the indices of hemodynamics and myocardial mechanics were improv ed obviously within 2 hours of resuscitation.

关 键 词：烧伤 休克 延迟复苏 血流动力学 

分 类 号：R644[医药卫生—外科学]