高氧复方氯化钠溶液用于大鼠烧伤后休克的观察

目的观察并探讨高氧复方氯化钠溶液对烧伤休克的防治作用. 方法 (1)将Wistar大鼠分为6组,A组正常对照组;B组制作30%TBSAⅢ度烧伤模型,伤后1 h补充复方氯化钠溶液;C组致伤后6 h补充复方氯化钠溶液;D组伤后1 h补充高氧复方氯化钠溶液;E组伤后6 h补充高氧复方氯化钠溶液;F组致伤后不治疗.动态观察各组大鼠内毒素(LPS)、白细胞介素6(IL-6)、二胺氧化酶(DAO)活性、D-乳酸、丙二醛(MDA)的变化.(2)选择烧伤面积为50%～69%TBSA、伤后3 h内入院的患者,随机分为治疗组补充高氧复方氯化钠溶液;对照组补充复方氯化钠溶液.观察患者休克期变化、经皮氧分压、血红蛋白、血细胞比容及有无并发症等. 结果大鼠伤后各组监测指标水平均较A组显著升高,呈逐步上升趋势,F组更加明显,其顺序为F组>C组>B组>E组>D组(P＜0.05).烧伤患者治疗组较对照组休克期度过平稳,补液量减少,氧分压明显升高,并发症少,但血氧饱和度差异无显著性意义. 结论早期应用高氧复方氯化钠溶液,对防治烧伤休克有较好的疗效.

Observation of the effect of hyperoxic sodium chloride solution on hypoxic injury

Objective To observe and explore the effects of compound hyperoxic sodium chloride solution on the management of burn shock. Methods (1)Wistar rats were randomly divided into 6 groups, i.e. A group(normal rats as control), B and C groups(the rats of 30% TBSA full thickness burn with compound sodium chloride solution at 1 and 6 postburn hours(PBHs) respectively); D and E groups(with hyperoxic sodium chloride solution at 1 and 6 PBHs respectively), and F group(without treatment). The changes in the serum contents of LPS, IL-6, DAO, D-lactate and MDA in the rats of each group were observed dynamically. (2) The burn patients admitted within 3 PBHs with 50%-69% TBSA burns were enrolled in the study and were randomly divided into the treatment( with hyperoxic sodium chloride solution) and the control(with sodium chloride solution) groups, The changes during shock stage, the postburn complications and the changes in the PtcO 2 and the serum contents of Hb, Hct were observed. Results All indices examined in B,C, D and E groups were evidently higher than those in A group in a progressive manner, especially in F group. The sequence was as follows:F group>C group>B group>E group>D group(P<0.05). The patients in treatment group could undergo the shock stage more steadily with decreased ammount of fluid infusion and increased PO 2 and less complications when compared with those in control group. But there was no obvious difference of the content of blood oxygen saturation between the two groups. Conclusion Application of hyperoxic sodium chloride solution during the early postburn stage could be beneficial to the management of burn shock.