延迟快速复苏对烫伤休克犬血液粘度的影响

目的：探讨烧伤后延迟复苏情况下,快速补液对血液粘度的影响。方法：利用犬40%TBSAⅢ度烫伤模型,32只狗被随机分为烫伤对照组、血定安延迟均匀补液组、血定安延迟快速补液组和血浆延迟快速补液组进行补液,观察伤前、伤后2、6、8、12、24、36和48h股动脉血压、血液粘度、血浆粘度和红细胞聚集性等指标的变化。结果：血液粘度伤后2h即显著高于伤前,补液后血液粘度等流变学指标均开始下降,快速被液2h后,快速补液组各流变学指标均低于均匀补液组,而血定安组的血液粘度和红细胞聚焦性显著低于血浆组。结论：在烫伤后延迟复苏情况下,快速补液可以迅速降低血液高粘滞状态,可能对改善微循环纠正休克有积极作用。

Effect of delayed rapid fluid resuscitation on blood viscosity in burn shock dogs

Objective To investigate the effect of rapid fluid replacement on hemorheology in delayed resuscitation after burn. Methods A total of 32 dogs inflicted with 40%TBSA full thickness scalding were randomly divided into 4 groups: scald control group(C group), delayed Gelofusion even replacement group (GE group), rapid fluid replacement group (GR group), and delayed plasma rapid fluid replacement group (PR group). The femoral arterial pressure, viscosity of blood and plasma, packed cell volume and aggregation of RBC were detected at the intervals of before and 2, 6, 8, 12, 24, 36 and 48 hours after scalding. Results The viscosity of blood markedly increased at 2 hours after scalding, and the hemorheology parameters decreased after fluid resuscitation. The hemorheologic parameters were obviously lower in GR group than in GE group at 2 hours after rapid resuscitation, the viscosity of blood and RBC aggregation in GR group were obviously lower than those in PR group. Conclusion Under the condition of delayed resuscitation after burn, rapid fluid replacement can quickly decreased the state of blood high viscosity and may play a role in improving microcirculation and treating burn shock.