严重烧伤休克期切痂对休克复苏影响的实验研究

目的 探讨烧伤休克期切痂的可行性及其对休克复苏的影响。方法 采用40%TBSAⅢ度烫伤犬模型，随机分为切痂组（E组）和非切痂组（C组）。伤后1h按Parkland公式补给平衡盐溶液，E组动物伤后3h切痂。分别于伤前及伤后30min和3、6、12、24、48h检测血流动力学、血液流变学业、氧代及血浆氧自由基变化。结果 烧伤后30min，CO明显下降，全血粘度、血浆粘度、红细胞聚积指数和血乳酸含量明显增加，切痂后，E组动物上述指标较C组明显改善。结论 休克期切痂能较早地纠正血流动力学、血液流变学紊乱及氧代谢障碍，减轻氧自由损伤，有利于烧伤休克的复苏。

Feasibility of escharectomy during burn shock period and its effect on resuscitation in dogs with severe scalding

Objective To study the feasibility of escharectomy during burnshock period and the effects on resuscitation in severe burn. Methods Dogs were inflicted with 40% TBSA of Ⅲ degree burns and divided into escharectomy group (E group) and non-escharectomy (C group). All subjects were infused with balanced salt solution intravenously in 1 h postburn according to the Parkland formula. The group E underwent Escharectomy was performed 3 hours after burnt. The changes of hemodynamics, blood rheolgy, oxygen metabolism, oxygen radicals were detected in all subjects before and 30 min, 1, 3, 6, 12, 24 and 48 h postburn. Results In 30 min postburn, CO (cardiac output), in all subjects was decreased obviously, blood and plasma viscosity, aggregation index of RBC and blood lactate acid content were increased obviously. After escharectomy, the changes were improved in E group. Conclusion Escharectomy during shock period causes no side effect against the host but can correct hemodynamics, blood rheology disturbances and disturbances of oxygen metabolism. Therefore, it can lessen the injury caused by oxygen radicals following burns.