丙酮酸盐糖液对烫伤大鼠肠内补液时肠黏膜血流量及Na^+-K^+-ATP酶活性和吸收效率的影响  

Effect of Pyruvate-enriched ORS on intestinal mucosal blood flow,activity of Na^+-K^+-ATPase and intestinal absorption rate during enteral resuscitation of scalded rats

作　　者：刘维维[1] 赵莹[2] 李娟[2] 喻文[2] 白晓东[1] 张慧萍[2] 胡森[2] 盛志勇[2] 

机构地区：[1]武警总医院烧伤整形科,北京医学硕士研究生100039 [2]解放军总医院第一附属医院烧伤研究所休克与多器官障碍实验室,北京100048

出　　处：《医学研究生学报》2014年第12期1258-1261,共4页Journal of Medical Postgraduates

基　　金：全军医学科学技术研究"十一五"计划课题(06Z055)

摘　　要：目的口服胃肠道补液是战时、火灾等恶劣条件下救治烧伤休克的一种简便易行且有效的方法,实践证明HCO3盐糖液有确切疗效。文中通过与之比较,研究丙酮酸盐糖液对35%总体表面积Ⅲ度烫伤大鼠肠内补液时肠黏膜血流量(intestinal mucosa bloodflow,IMBF)、Na+-K+-ATP酶活性和吸收效率的影响。方法雄性SD大鼠90只,随机数字表法分为5组:烫伤不补液组、HCO3盐糖液假烫组、丙酮酸(Pyruvat)盐糖液假烫组、HCO3盐糖液烫伤组、丙酮酸盐糖液烫伤组,每组18只,每组又分为伤后1.5 h和4.5 h亚组,分别检测小肠对水和Na+的吸收速率、IMBF和Na+-K+-ATP酶活性。结果与假烫组比较,烫伤补液组大鼠小肠对水和Na+的吸收速率均显著降低(P<0.05);自伤后1 h,丙酮酸盐糖液烫伤组对水和Na+的吸收速率均高于HCO3盐糖液烫伤组(P<0.05)。与假烫组比较,烫伤补液组大鼠的IMBF和Na+-K+-ATP酶含量在伤后1.5、4.5 h均明显降低(P<0.05);丙酮酸盐糖液烫伤组IMBF在伤后1.5、4.5 h[(95.250±5.096)、(112.765±7.215)U]明显高于HCO3盐糖液烫伤组[(80.764±7.852)、(94.671±8.469)U]差异有统计学意义(P<0.05)。结论丙酮酸盐糖液口服胃肠道补液可作为战时、火灾等恶劣条件下救治烧伤休克的一种简便有效的方法。Objective Gastrointestinal rehydration is a simple and effective method in treatment of burn shock during wartime, fire disaster and other harsh conditions, and practice has proved the exact curative effect of HCO3 salt sugar liquid. This article was to investigate the effect of pyruvate-enriched oral rehydration solution （Pyr-ORS） on intestinal mucosal blood flow （IMBF）, activity of Na ^＋ -K ＋ -ATPase and intestinal absorption rate during enteral resuscitation of a 35% TBSA third-degree scald in rats. Methods 90 male rats were randomly divided into 5 groups： scald without fluid resuscitation （S group）; sham scald resuscitated with HCO3 salt sugar liquid （ SS HCO3 group） ; sham scald resuscitated with Pyr-ORS （SS Pyr-ORS group）; scald resuscitated with HCO3 salt sugar liquid （S HCO3 group） ; scald resuscitated with Pyr-ORS （S Pyr-ORS group） （n = 18）. Each group was divided into 2 subgroups of 1.5 and 4.5 h after scald injury. Intestinal absorption rate of water and Na ＋ , IMBF and activity of Na ^＋ -K ^＋ -ATPase were detected on each group. Results Compared with shame scald groups, the intestinal absorption rates of water and Na ^＋ decreased obviously in scald groups with fluid resuscitation （P 〈 0. 05） ; at 1 h after scald injury, the intestinal absorption rates of water and Na ^＋ in S Pyr-ORS groups were both higher than those in S HCO3 groups（P 〈 0. 05）. Compared with shame scald groups, IMBF and activity of Na ^＋ -K^ ＋ -ATPase at 1.5 and 4.5 h after scald injury decreased obviously in scald groups with fluid resuscitation （P 〈 0.05 ） ; at 1.5 and 4.5 h after scald injury, IMBF in S Pyr-ORS groups （95. 250 ± 5. 096/112. 765 ±7. 215 ） were greater than those in S HCO3 group （ 80. 764 ± 7. 852/94.671 ± 8. 469）, which was of statistical significance （P 〈 0. 05 ）. Conclusion Pyr-ORS is a simple and effective method in treatment of burn shock during wartime, fire disaster and other harsh conditions.

关 键 词：烧伤 口服补液 丙酮酸盐口服溶液 NA+-K+-ATP酶 

分 类 号：R644[医药卫生—外科学]