小型猪烧伤后早期切痂时机的选择

Optimal time for early escharectomy after major burns

目的探讨小型猪严重烫伤后最佳切痂的时机。方法制作小型猪35%TBSAⅢ度烫伤模型,随机分两组伤后6h切痂为A组,伤后24h切痂为B组,每组7只。分别于伤前及伤后不同时相点检测两组猪的血液动力学、血液流变学指标的变化及血清中细胞因子含量。结果与B组比较,A组猪血液动力学指标改善明显,心输出量(CO)及右心房压(RAP)伤后48h已恢复伤前水平,分别为(2.23±0.02)L/min、(4.54±0.04)mmHg。两组猪血液流变学指标无统计学意义(P>0.05)。A组伤后1周细胞因子含量均降至伤前水平;B组仍高于伤前水平及A组(P<0.05或001)。结论小型猪大面积严重烧伤后6h切痂安全可行,能有效预防远期并发症。

Objective To investigate optimal time for early escharectomy after severe scald in minipigs. Methods Minipigs inflicted with 35% TBSA full thickness burn were employed in the study, and they were randomly divided into A (n=7, with escharectomy at 6PSH), and B (n=7, with escharectomy at 24 PSH) groups. The hemodynamics indices, hemorrheology, and the serum levels of cytokines in the two groups were determined before burns and at 6, 8, 16, 24 and 72PSH. Results The hemodynamics indices in A group obviously improved compared with those in B group. The cardiac output (CO, 2.28±0.03 L/min) and right arterial pressure (RAP, 4.54±0.04 mmHg) in A group recovered to the pre-injury levels at 48 PSH. There was no difference of the hemorrheology indices between the two groups (P>0.05). The serum contents of cytokines in A group declined to the pre-injury level on 1 PBW, while those in B group were significantly higher than those before injury and those in A group (P<0.05 or P>0.01). Conclusion Escharectomy during 6 PBH might be safe and feasible, thus preventing long-term complications effectively.