早期手术对烧伤大鼠肝血流量的影响

目的通过测定 TBSA30％Ⅲ度烧伤大鼠早期手术后肝血流量的变化,了解早期手术对肝脏血液灌流的影响。方法 Wistar 雄性大鼠34只,分为4组:烧伤组(A 组),输液组(B 组),早期手术组(C 组),正常对照组(D 组)。输液组经股静脉插管输入乳酸林格氏液;早期手术组于立即补液的同时行切痂同种异体植皮术。各组于伤后0,0.5,1,2,3,6,12和24小时,应用氢清除法测定肝血流量。结果 A 组与 B 组伤后均出现肝血流量显著下降,B 组直至伤后24小时肝血流量才恢复正常,而 C 组伤后肝血流量保持相对稳定,与正常对照组比较无显著意义。结论严重烧伤后立即液体复苏尚不足以维持有效的肝脏血流灌流,烧伤后早期手术尽早地去除焦痂组织,对改善肝血流量具有重要作用。

Effects of early wound excision on hepatic blood flow in burned rats

Objective To evaluate the effects of early burn wound excision and skin grafting on the hepatic blood flow(HBF)in comparison with infusion treatment after severe burn injury in rats. Methods Thirty-four male Wistar rats were allocated to four groups of eight to ten animals.The com- mon femoral vein and midline laparotomy for placing a platinum electrode on the surface of the liver were performed under pentobarbital anesthesia.After 24 hours,the rats underwent different treat- ment,as follows.The burn group(A group,n=8)received a burn injury only.The burn infusion group(B group,n=8)was infused with lactated Ringer's solution after being burned.The burn infu- sion early excision group(C group,n=8)underwent escharectomy and allografting with fluid resusci- tation after being burned.The sham group(D group,n=10)received anesthesia and underwent a sham burn procedure.The HBF was measured at 0,0.5,1,2,3,6,12 and 24 hours postburn in each group us- ing the hydrogen gas clearance method.Results A significant decrease in HBF was found in both the A and B groups after burn.On the other hand,the C group showed similar changes in HBF as the D group.Conclusion The HBF decreases postburn even with continuous fluid resuscitation,but it is maintained stable by early wound excision and allo-skin grafting with fluid resuscitation.These findings indicated that early excision is helpful in stabilizing the HBF without further aggravating the hepatic hemodynamic load.