Hu Quan, Hu Sen, Chai Jia-ke, Shen Xiao-peng, Che Jin-wei, Sheng Zhi-yong
Burns Institute, First Hospital Affiliated to the PLA General Hospital, Beijing 100037, China.
Zhonghua Wai Ke Za Zhi. 2009 Oct 15;47(20):1581-4.
To study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) in enteral resuscitation of burn shock.
Eighteen Beagle dogs with 35% TBSA full-thickness flame injury were used in this study. They were randomized to a control group (no-fluid resuscitation, N group), a HEGS resuscitation group (H group) or an isotonic electrolyte glucose solution (IEGS) resuscitation group (I group). The solution enterally was given for resuscitation from half an hour after burn. The volumes and rates of fluid infusion in the H group were basically in accordance with 2 ml/(kg x 1%TBSA), those in the I group were basically in accordance with parkland formula [4 ml/(kg x 1%TBSA)]. The haemodynamic parameters, global end-diastolic volume index, plasma volume, osmotic pressure of plasma, intestinal absorptive rates of water and Na(+), and intestine mucosa blood flow were continuously assessed.
The cardiac output index, global end-diastolic volume index, plasma volume and intestine blood mucosa flow reduced markedly after burn in the three groups, and then gradually returned from 2 h after burn in two resuscitation groups, which were higher than that in the N group (P < 0.05). The activities of diamine oxidase in plasma in the two resuscitation groups were higher than that in N group (P < 0.05). The intestinal absorption rates of water and Na(+) reduced markedly after burn in two resuscitation groups with the lowest levels, and then returned from 6 h after burn. The rates of water in H group were lower than that in I group (P < 0.05); the rates of Na(+) in H group were higher than in I group (P < 0.05).
The results indicated that 35%TBSA III degrees burn-injury dogs be resuscitated effectively with 1.8% hypertonic electrolyte-glucose solution by enteral, which 1/2 volume of an isotonic electrolyte glucose solution.
研究高渗电解质葡萄糖溶液(HEGS)在烧伤休克肠内复苏中的复苏效果。
选用18只35%体表面积全层火焰烧伤的比格犬。将它们随机分为对照组(无液体复苏,N组)、HEGS复苏组(H组)或等渗电解质葡萄糖溶液(IEGS)复苏组(I组)。烧伤后半小时开始经肠道给予溶液进行复苏。H组的输液量和速率基本按照2 ml/(kg×1%TBSA),I组基本按照帕克公式[4 ml/(kg×1%TBSA)]。持续评估血流动力学参数、全心舒张末期容积指数、血浆容量、血浆渗透压、肠道水和钠的吸收率以及肠黏膜血流量。
三组犬烧伤后心输出量指数、全心舒张末期容积指数、血浆容量和肠黏膜血流量均显著降低,两个复苏组在烧伤后2小时开始逐渐恢复,且高于N组(P<0.05)。两个复苏组血浆中二胺氧化酶的活性高于N组(P<0.05)。两个复苏组烧伤后肠道水和钠吸收率显著降低,达到最低水平后从烧伤后6小时开始恢复。H组水的吸收率低于I组(P<0.05);H组钠的吸收率高于I组(P<0.05)。
结果表明,1.8%高渗电解质葡萄糖溶液经肠道可有效复苏35%体表面积Ⅲ度烧伤犬,其用量为等渗电解质葡萄糖溶液的1/2。