摘要
目的探讨对重度烧伤休克期猪应用不同胶体进行液体复苏对其氧代谢的影响。方法将18只成年广西巴马小型猪造成背部约40％TBSAⅢ度烧伤，按随机数字表法分成琥珀酰明胶组、羟乙基淀粉组、异体血浆组，每组6只；伤后2h开始进行液体复苏，胶体分别使用琥珀酰明胶、60g／L羟乙基淀粉130／0．4、异体血浆。记录各组猪伤前及伤后第1、2个24h的血压、尿量、心率、中心静脉压（CVP），伤后第1、2个24h复苏液体量，测定并计算伤前及伤后4、8、24、48h的氧摄取量、氧供量、氧摄取率及血液中D哥L酸的含量。对数据行重复测量方差分析、单因素方差分析及LSD检验。结果各组猪各时相点血压、尿量、心率及CVP比较，差异均无统计学意义（P值均大于0．05）。琥珀酰明胶组、羟乙基淀粉组、异体血浆组猪第1、2个24h复苏液体量组间比较差异均无统计学意义（F值分别为0．239、2．023，P值分别为0．790、0．167）。伤后48h琥珀酰明胶组猪氧摄取量为（201±38）L·min-1·m-2，显著高于异体血浆组的（150．4-37）L·min-1·m-2，P〈0．05；其余时相点3组猪氧摄取量水平差异无统计学意义（P值均大于0．05）。琥珀酰明胶组猪伤后8h的氧供量为（484±63）L·min-1·m-2，低于异体血浆组的（652±65）L·min-1·m-2，P〈0．01；而伤后24、48h的氧供量分别为（903±132）、（1028±98）L·min-1·m-2，分别显著高于异体血浆组的（686±72）、（720±75）L·min-1·m-2，P值均小于0．01。羟乙基淀粉组猪各时相点氧供量与异体血浆组相近（P值均大于0．05）。各时相点琥珀酰明胶组、羟乙基淀粉组猪氧摄取率与异体血浆组相近（P值均大于0．05）。伤后48h时琥珀酰明胶组猪血液中D哥L酸含量为（69±9）mmol／L，显著高于异体血浆组的（52±4）mmol／L，P〈0．01；3组猪余各时相点D-乳酸含量相近（P值均大于0．0
Objective To explore the effects of resuscitation with different kinds of colloids on oxy- gen metabolism of swine during shock stage of burn injury. Methods Eighteen Guangxi Bama miniature swine were inflicted with 40% TBSA full-thickness burn on the back. And then they were divided into succi- nylated gelatin group （S） , hydroxyethyl starch group （H） , and allogeneic plasma group （A） according to the random number table, with 6 swine in each group. The fluid resuscitation was begun at post injury hour （PIH） 2. The colloids used in groups S, H, and A were respectively succinylated gelatin, 60 g/L hydroxy- ethyl starch 130/0.4, and allogeneic plasma. The blood pressure, urine volume, heart rate, and central ve- nous pressure （CVP） were recorded before injury and at the first and second PIH 24. The volume of resusci- tation fluid was recorded at the first and second PIH 24. The changes in oxygen delivery, oxygen consump- tion, oxygen extraction ratio and D-lactate were determined and calculated before injury and at PIH 4, 8, 24, and 48. Data were processed with analysis of variance of repeated measurement, one-way analysis of va- riance, and LSD test. Results There were no statistically significant differences among the three groups in blood pressure, urine volume, heart rate, and CVP at each time point （with P values above 0.05 ）. There were no statistically significant differences in resuscitation fluid volume among the three groups at the first and second PIH 24 （ with F values respectively 0. 239 and 2. 023, P values respectively 0. 790 and 0. 167）. The oxygen consumption of swine in group S was （201 ± 38） L · min-1 · m-2 at PIH 48, which was signifi- cantly higher than that in group A I（150＋37） L· min-1 · m-2, p 〈0.05], and the oxygen consumption was similar among the three groups at the rest time points （with P values above 0.05）. The oxygen delivery of swine in group S was （484 ±63） L · min-1 · m-2 at PIH 8, and it was significantly lower than that in
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2015年第3期211-215,共5页
Chinese Journal of Burns
基金
浙江省科技计划（2010C33009）
关键词
烧伤
休克
补液疗法
胶体
氧代谢
Burns
Shock
Fluid therapy
Colloid
Oxygen metabolism
