烧伤后早期口服液体复苏与静脉液体复苏的对比研究

目的:通过烧伤后早期口服液体复苏(EOFR)与静脉液体复苏的对比研究,探讨EOFR对烧伤休克时循环和组织灌流的影响,评价其对烧伤休克的复苏效果.方法:选择32只杂种犬复制30%体表面积(TBSA)Ⅲ度烧伤模型,并随机分为不复苏对照(NR)组、口服WHO ORS液(WOR)组、口服林格氏液(LOR)组、林格氏液静脉复苏对照(LVR)组,检测不同时间点平均动脉压(MAP)、胃黏膜pH值、24小时尿量及病死率等指标.结果:WOR组和LOB组的MAP、胃黏膜pH值、24小时尿量较LVR组显著降低,但明显高于NR组(P＜0.05,P＜0.01).NB组24、48小时病死率为62.5%和100.0%,明显高于WOR组、LOR组及LVR组(P＜0.01).结论:EOFR可有效改善30%TBSAⅢ度烧伤的循环指标,恢复重要脏器血液灌流,部分替代静脉液体复苏.

A Comparative Study of Oral Fluid Resuscitation with Vein Fluid Resuscitation in Dogs in the Early Stage after Burn Injury

Objective:To study the effects of early oral fluid resuscitation on circulation and tissue perfusion after burn injury in comparison with vein fluid resuscitation.Methods:Thirty two hybrid dogs were randomly divided into four groups(n=8,in each group):burn without resuscitation,burn with vein fluid resuscitation,burn with either oral WHO ORS(oral rehydration salt) or Ringers solution.Mean arterial blood pressure and gastric mucosa pH at 0,3,6,9,24,48 hours postburn were determined.Urinary volume and mortality in 48 hours were also recorded.Results:Compared with vein fluid resuscitation control,mean arterial pressure,gastric mucosa pH and urinary volume in 24 hours in oral WHO ORS and Ringers solution groups were significantly lower than that of LVR group,but higher than those of non-resuscitation group.Mortality of 24,48 hours in non-resuscitation group were 62.5% and 100.0%,being the highest in the four groups.Conclusion:Early oral fluid resuscitation can improve circulation dysfunction and restore vital organs perfusion after burn injury,and may in part replace vein fluid resuscitation.