快速补液对烧伤延迟复苏红细胞膜力学特性的影响

目的　探讨快速补液对烧伤延迟复苏大鼠的红细胞膜力学特性和心肌局部血流量的影响。方法　采用大鼠 3 0 %TBSAⅢ度烧伤延迟复苏快速补液和均匀补液的动物模型 ,用微管吸吮法测定其伤前和伤后 1、3、6、12、2 4、4 8h红细胞膜的弹性模量和粘性系数等力学参数 ;同时 ,用氢清除法测定心肌局部血流量。结果　伤后 1h ,红细胞膜的弹性模量和粘性系数显著升高 ,伤后 6h达高峰。补液后 ,两组均逐渐下降 ,RI组的下降幅度明显大于AI组 ,至伤后 2 4h ,两组恢复到相互接近 ,但仍高于伤前。同时 ,伤后 1h ,心肌局部血流量即显著降低 ,至伤后 6h ,达到最低点 ,补液后 ,两组均逐渐增高 ,RI组的增高幅度明显大于AI组 ,至伤后 4 8h恢复接近正常。二者呈明显负相关。结论　烧伤后红细胞膜变形能力下降 ,导致心肌局部血流量减少 ,是烧伤后心肌缺血性损害的重要原因之一。快速补液能够改善红细胞膜的力学特性和心肌微循环血液灌注 ,从而减轻心肌的缺血缺氧性损害。

The effect of rapid infusion on erythrocyte membrane viscoelasticity of delayed resuscitation burned rats

Objective To study the dynamic changes of erythrocyte membrane viscoelasticity and the effect on myocardial region blood flow to delayed resuscitation burned rats with rapid infusion.Methods The authors made the models of 30% TBSA Ⅲ degree bured rats with rapid infusion(RI groups)and average infusion(AI groups)to delayed resuscitation,the erythrocyte membrane viscoelasticity at preburn and 1?3?6?12?24?24?48h postburn were measured with micropipe sucking.Meanwhile,the volume of myocardial region blood flow were measured with H 2 clearance method.Results The erythrocyte membrane viscoelasticity began to increase at 1h postburn and reached the peak level at 6h postburn.After infusion,they gradually decreased and RI group decreased faster than AI group.Corresponding,the myocardial region blood flow began to decrease at 1h postburn and reached the peak level at 6h postburn.Then,gradually increased until 48h postburn near to preburn level.RI group increased faster than AI group.Conclusion These findings suggest that erythrocyte deformability decreased in early burn stage was one of the causes by which the volume of myocardial region blood flow decreased,thus myocardium suffered from ischemia damage,but rapid infusion could lighten myocardium ischemia damage.