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对于二度实验性烧伤且延迟开始维生素C治疗(伤后6小时开始)的情况,复苏液量减少。

Reduced resuscitation fluid volume for second-degree experimental burns with delayed initiation of vitamin C therapy (beginning 6 h after injury).

作者信息

Sakurai M, Tanaka H, Matsuda T, Goya T, Shimazaki S, Matsuda H

机构信息

Burn Center, Cook County Hospital, Chicago, Illinois, USA.

出版信息

J Surg Res. 1997 Nov;73(1):24-7. doi: 10.1006/jsre.1997.5203.

Abstract

We studied the hemodynamic effects of delayed initiation (6 h postburn) of antioxidant therapy with high-dose vitamin C in second-degree thermal injuries. Seventy percent body surface area burns were produced by subxiphoid immersion of 12 guinea pigs into 100 degrees C water for 3 s. The animals were resuscitated with Ringer's lactate solution (R/L) according to the Parkland formula (4 ml/kg/% burn during the first 24 h) from 6 h postburn, after which the resuscitation fluid volume was reduced to 25% of the Parkland formula volume. Animals were divided into two groups. The vitamin C group (n = 6) received R/L to which vitamin C (340 mg/kg/24 h) was added after 6 h postburn. The control group (n = 6) received R/L only. Both groups received identical resuscitation volumes. Heart rates, mean arterial blood pressure, cardiac output, hematocrit level, and water content of burned and unburned tissue were measured before injury and at intervals thereafter. No animals died. There were no significant differences in heart rates or blood pressures between the two groups throughout the 24-h study period. The vitamin C group showed significantly (P < 0.05) lower hematocrits 8 and 24 h postburn, and higher cardiac outputs after 7 h postburn. At 24 h postburn, the burned skin in the vitamin C group had a significantly (P < 0.05) lower water content (73.1 +/- 1.1) than that of the control group (76.0 +/- 0.8). In conclusion, delayed initiation of high-dose vitamin C therapy beginning 6 h postburn with 25% of the Parkland formula volume significantly reduced edema formation in burned tissue, while maintaining stable hemodynamics.

摘要

我们研究了大剂量维生素C抗氧化疗法延迟启动(烧伤后6小时)对二度热损伤的血流动力学影响。将12只豚鼠剑突下浸入100摄氏度水中3秒,造成70%体表面积烧伤。从烧伤后6小时开始,根据Parkland公式(最初24小时内4毫升/千克/%烧伤面积)用乳酸林格氏液(R/L)对动物进行复苏,之后复苏液量减至Parkland公式量的25%。动物分为两组。维生素C组(n = 6)在烧伤后6小时接受添加了维生素C(340毫克/千克/24小时)的R/L。对照组(n = 6)仅接受R/L。两组接受相同的复苏液量。在受伤前及之后的不同时间间隔测量心率、平均动脉血压、心输出量、血细胞比容水平以及烧伤和未烧伤组织的含水量。无动物死亡。在整个24小时研究期间,两组之间的心率或血压无显著差异。维生素C组在烧伤后8小时和24小时血细胞比容显著较低(P < 0.05),在烧伤后7小时后心输出量较高。在烧伤后24小时,维生素C组烧伤皮肤的含水量(73.1 +/- 1.1)显著低于对照组(76.0 +/- 0.8)(P < 0.05)。总之,烧伤后6小时开始以Parkland公式量的25%延迟启动大剂量维生素C疗法可显著减少烧伤组织中的水肿形成,同时维持稳定的血流动力学。

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