高张盐右旋糖酐液对烧伤休克延迟复苏心肌功能的影响

Effects of hypertonic saline/dextran 70 on cardiac function in delayed resuscitation of burn shock

目的：探讨高张盐右旋糖酐液（ＨＳＤ）在烧伤休克延迟复苏中的作用及其对心肌功能的影响。方法：观察ＨＳＤ在犬３５％ＴＢＳＡⅢ度烧伤６ｈ后复苏中的容量负荷、ＭＡＰ、ＬＶＳＰ、ＬＶＥＤＰ、＋ｄｐ／ｄｔｍａｘ、－ｄｐ／ｄｔｍｉｎ、ＣＯ及ＳＶＲ的变化。结果：ＨＳＤ在烧伤休克延迟复苏伤后第一个２４ｈ的输液量比乳酸林格液复苏少３０．５６％，其中复苏后４ｈ的输液量比乳酸林格液复苏少５９．５０％，并且能增加心肌的收缩、舒张功能，提高前负荷，降低后负荷及增加心输出量。结论：ＨＳＤ在烧伤休克延迟复苏中能发挥其容量负荷小，扩容效果好及改善心肌功能等特点。

Objective:To investigate the effects of hypertonic saline/dextran 70 (HSD) on cardiac function in delayed resuscitation of burn shock.Methods:HSD was used for resuscitation 6 h after burn shock of dogs and its effect on cardiac function was evaluated by volume load, MAP, LVSP, LVEDP, +dp/dt max , -dp/dt max , CO and SVR.Results:The volume of resuscitated solution with HSD was less 30.50% during first 24 h postburn and less 59.50% during 4 h after resuscitation than LRs. The MAP, LVSP, LVEDP, +dp/dt max , -dp/dt max and CO were increased and SVR was reduced with HSD resuscitation.Conclusion:HSD can expand plasma volume significantly with small volume solution and cardiac function is improved during delayed resuscitation of burn shock.