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[严重烧伤后早期多器官功能衰竭的实验研究]

[Experimental study on early multiple organ failure after severe burns].

作者信息

Chen F M

机构信息

Burn Research Institute, First Affiliated Hospital of Third Military Medical College.

出版信息

Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1992 Mar;8(1):16-21, 84-5.

PMID:1596785
Abstract

Forty-three male mongrel dogs (12.5 +/- 2.5 kg) were divided into normal control (n = 7), immediate infusion (n = 8), non-infusion (n = 13) and delayed infusion (n = 15) groups. A 50% TBSA third degree surface burn was produced by igniting 3% napalm for 30 seconds on the shaved back. Cardiac, pulmonary, hepatic, renal and gastrointestinal functions were monitored following the thermal injury. The findings of these studies showed that mean arterial pressure, cardiac index, left ventricular work, right ventricular work, ADP/O ratio and ATP were all significantly decreased (P less than 0.05). However pulmonary artery wedge pressure, pulmonary vascular resistance, systemic vascular resistance, P(A-a)O2, Beef, Cr, UN, ALT, LDH, TB, DB, and MDA were markedly increased (P less than 0.05). Severe shock occurred soon after burns. Thirteen dogs died within 12 hours in the non-infusion group. All the dogs were resuscitated when immediate infusion of lactic acid Ringers solution was given according to Parkland formula, and all of them tide over shock stage smoothly without obvious changes in visceral functions. However, dogs were not resuscitated when infusion was delayed 6 hours postburn. The changes in visceral were even more severe in this group than those in non-infusion group. These results demonstrated that delayed resuscitation was an important factor of MOF in the early postburn stage. The marked increase in MDA in the myocardiac, lung, liver, renal and gastrointestinal tissues indicated that lipoperoxidation by free oxygen radicals was closely related with visceral damages.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

43只雄性杂种犬(体重12.5±2.5千克)被分为正常对照组(n = 7)、即刻输液组(n = 8)、非输液组(n = 13)和延迟输液组(n = 15)。通过在剃毛的背部用3%凝固汽油点燃30秒造成50%体表面积的三度体表烧伤。热损伤后监测心脏、肺、肝、肾和胃肠道功能。这些研究结果显示,平均动脉压、心脏指数、左心室作功、右心室作功、ADP/O比值和ATP均显著降低(P<0.05)。然而,肺动脉楔压、肺血管阻力、全身血管阻力、P(A-a)O2、Beef、Cr、UN、ALT、LDH、TB、DB和MDA均显著升高(P<0.05)。烧伤后很快发生严重休克。非输液组13只犬在12小时内死亡。按照Parkland公式即刻输注乳酸林格液时,所有犬均得以复苏,且均顺利度过休克期,内脏功能无明显变化。然而,烧伤后延迟6小时输液时犬未得到复苏。该组内脏变化比非输液组更严重。这些结果表明,延迟复苏是烧伤后早期多器官功能衰竭的一个重要因素。心肌、肺、肝、肾和胃肠道组织中MDA的显著升高表明,氧自由基引起的脂质过氧化与内脏损伤密切相关。(摘要截短至250字)

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