严重烧伤后输液对多器官功能障碍综合征的病理组织学和超微结构变化的影响

目的　探讨严重烧伤后输液对多器官功能障碍综合征的病理组织学和超微结构变化的影响。　方法　犬 4 4只 ,随机分为立即输液组 (8只 )、延迟输液组 (15只 )、不输液组 (14只 )及正常对照组 (7只 )。质量浓度为 30 g/L的凝固汽油燃烧 30s,致TBSA 5 0 %Ⅲ度烧伤。伤后 72h或濒死期自心、肺、肝、肾和胃肠各取小块组织作光镜和透射电镜观察。　结果　伤后心、肺、肝、肾及胃肠组织均有不同程度的血液循环障碍及退行性变 ,延迟输液组器官病变较立即输液组及不输液组者重。结论　伤后延迟输液是严重烧伤早期并发多器官功能障碍的重要原因。

The effects of postburn fluid resuscitation on the pathohistological and ultrastructural changes of multiple organs with dysfunction in severely burned dogs

OBJECTIVE: To investigate the effects of postburn fluid resuscitation on the pathohistological and ultrastructural changes of multiple organs with dysfunction in severely burned dogs. METHODS: Forty - four mongrel dogs were randomly divided into four groups: (1) immediate infusion (II, n = 8), (2) delayed infusion (DI, n = 15), (3) no infusion (NI, n = 14), (4) normal control (NC, n = 7). The dogs were inflicted with 50% TBSA III degree flame burn produced by napalm in concentration of 30g/L burning for 30 seconds on the back. Small pieces of tissue samples of heart, lungs, liver, kidneys and gastrointestinal tract were taken from injured dogs at 72 postburn hours (PBHs) or moribund stage for the examination with light microscope (LM) and transmission electron microscope (TEM). RESULTS: Different degrees of blood circulation disturbance and degenerative changes were found in all above internal organs. These changes were more evident in DI than in II and NI groups. CONCLUSION: Delayed postburn fluid resuscitation could induce multiple organ dysfunction in early postburn stage.