严重烧伤病人休克期应用山莨菪碱的意义

RESEARCH OF THE APPLICATION OF ANISODAMINE TO PATIENTS WITH SERIOUS BURNS

观察了１６例大面积烧伤病人，发现。烧伤后胃肠缺血发生快而恢复慢，血供恢复滞后于血流动力学参数的恢复。常规治疗组伤后血浆中内毒素（ＬＰＳ）、肿瘤坏死因子（ＴＮＦ）、二胺氧化酶（ＤＡＯ）持续高于正常水平，ｐＨｉ恢复慢。应用山莨菪碱后上述指标逐渐恢复。从而说明：大面积烧伤早期胃肠缺血很普遍，持续胃肠缺血可使肠粘膜损伤，导致内毒素移位。山莨菪碱对胃肠道有保护作用，可阻止内毒素移位。

Sixteen seriously burned patients were observed in this study.The patients were divided into two groups,group C,fluid resuscitation was given routinely;group A,beside fluid resuscitation anisodamine was used for 3 days.We confirmed that gastrointestinal ischemia occurred rapidly but recovered slowly.In group C there were significant increase in plasma LPS、TNF、DAO,and lowering pHi.On the contrary,plasma LPS、TNF、DAO and pHi recovered gradually with the use of anisodamine in group A.The results of this study demonstrated that gastrointestinal ischemia occurred commonly after serious burns.Prolonged gastrointestinal ischemia could produce injury to intestinal mucosal barrier,inducing LPS translocation.The administration of anisodamine was shown to have the effect of restoring gastrointestinal circulation and averting LPS translocation.