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高渗氯化钠对重度烧冲复合伤早期治疗的实验研究

Preliminary study of the therapeutic effect of hypertonic saline in the early stage of severe combined burn-blast injury

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【作者】 朱佩芳周继红周元国邹用志刘大为刘怀林李晓炎

【Author】 Zhu Peifang;Zhou Jihong;Zhou Yuanguo;Zou Yongzhi;Liu Dawei;Liu Huailin;Li Xiaoyan(Research Institute of Field Surgery, Third Military Medical College,Chongqing,630042)

【机构】 第三军医大学野战外科研究所

【摘要】 为探讨高渗盐液在烧冲复合伤早期复苏时使用的可能性。用狗30只,分别致成25%体表Ⅲ度烧伤复合中度冲击伤。伤后分3组给与不等量的水和钠。伤后第1个24h,致伤对照组、高渗盐液和晶胶治疗组分别给钠为0.123mmol·kg-1·1%BSA-1、0.500mmol·kg-1·1%BSA-1和0.304mmol·kg-1·1%BSA-1。3组均于伤后2h开始给液。结果显示,高渗盐液组给液后脉压改善,中心静脉压恢复正常,血液流变的改善优于其他两组;虽总给液量高于对照组,但肺水量较对照明显为低(P<0.05)。血渗各组差别不明显,但两治疗组尿渗明显为高。实验证实,高渗盐液在本实验伤情条件下作复苏用是安全、有效的,未加重肺水肿。文中对高渗盐液的治疗作用及尿渗偏高的机制进行了讨论。

【Abstract】 Thirty dogs were inflicted with a combined injury of 25%TBSA full thickness burns and moderate blast injury. They were divided into 3 groups. In the 2nd hour after injury, Group l(the control)was infused with 0.123 mmol/L of NaCl/kg/l%BSA, Group 2 with 0.500 mmol/L of NaCl/kg/l%BSA and Group 3 with 0.304 mmol/L of NaCl/kg/l%BSA. It was found that after hypertonic saline(HS)was given,the pulse pressure was increased and the central venous pressure returned gradually to normal.The hemorrheological paramenters were more singificantly improved in HS group than in the other 2 groups. Though the total amount of the infused fluid was greater in HS group than in control group,the lung water content was far less in HS group than in the control(P<0.05).The changes of serum osmotic pressure showed no significant difference among the 3 groups.The findings indicate that HS is an effective and safe agent for the treatment of early severe conbined burn blast injury.It does not aggravate pulmonary edema due to blast injury,The mechanism of the therapeutic effects of HS was discussed.

  • 【文献出处】 第三军医大学学报 ,ACTA ACADEMIAE MEDICINAE MILITARIS TERTIAE , 编辑部邮箱 ,1994年04期
  • 【分类号】R644
  • 【被引频次】1
  • 【下载频次】24
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