摘要
我们对67例大面积烧伤病人(其中27例为延迟复苏患者)进行了前瞻性研究,并采用顺磁共振(ESR)技术动态观察了伤后1周内全血氧自由基含量,为烧伤早期自由基的存在提供了直接依据;同时还观察了全血超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSHpx)、血浆丙二醛(MDA)含量变化、结果表明:①延迟复苏患者烧伤休克发病率高、纠正困难且复苏失败率高。②延迟复苏患者MSOF发病率及病死率高。③延迟复苏患者伤后氧自由基生成量明显增多,脂质过氧化损伤明显增强,抗氧化机能明显减弱。④延迟复苏伴烧伤休克患者脂质过氧化损伤程度重于非延迟复苏伴烧伤休克患者。⑤延迟复苏并发多脏器功能衰竭(MSOF)患者脂质过氧化程度重于未并发MSOF患者。本研究结果提示:延迟复苏促进了烧伤后氧自由基损伤,而氧自由基损伤在烧伤后延迟复苏的病理生理过程中可能扮演了重要角色。
Sixty seven burn patients (TBSA>30%) were entered in a prospective study. Among them, twenty seven experienced delayed fluid resuscitation (DFR group) and the rest had early resuscitation (non-DFR group). Oxygen free radical(OFR) content in the blood was measured with ESR technic, and levels of blood SOD, blood GSHpx, serum MDA were also determined. The results showed: ①The morbidity and mortality of hum shock and MSOF were higher in DFR group as compared with non-DFR group. ①There was a significant increase of blood OFR content subsequent to resuscitation in DFR group as compared with that in non-DFR group. ①The level of MDA in the serum of patients with burn shock was higher in DFR group than that in non-DFR group. ④In DFR group, the level of serum MDA is higher in patients who developed MSOF as compared with that in patients who did not develop MSOF. The data indicated that DFR augumented the morbidity and mortality of burn shock and MSOF, in which OFR might play a role.
