模拟海上颠簸刺激加重严重烧伤家兔休克的研究

The effect of stimulation of toss simulated at sea on shock in severe burn rabbits

目的了解模拟海上颠簸刺激对烧伤家兔休克的影响。方法将132只家兔随机分为正常对照组（6只）、单纯颠簸组（行持续颠簸刺激，42只）、单纯烧伤组（行烧伤处理，42只）、烧伤颠簸组（烧伤后即刻进行持续颠簸刺激，42只）。后3组家兔于处理后2、6、8、12、24、36、48h经颈动脉取血，检测血清肌酐（Cr）、血清尿素氮（BUN）、血细胞比容（HCT）和血清乳酸（LA）水平，并取肾脏组织观察其病理学变化，同时留置导尿管持续监测家兔处理后第1、2个24h的尿量变化；正常对照组家兔亦行上述检测。结果烧伤颠簸组家兔血Cr、血BUN自处理后24h起明显高于单纯烧伤组（P〈0．01），血LA、HCT各时相点均显著高于单纯烧伤组（P〈0．01）。烧伤颠簸组家兔肾小球毛细血管和间质血管充血，肾小管上皮细胞肿胀，肾小管炎性细胞浸润及红细胞管型。单纯烧伤组病理变化轻于烧伤颠簸组。单纯烧伤组家兔处理后第1、2个24h尿量分别为（2．59±0．23）、（2．86±0．29）mL／h，烧伤颠簸组上述时相点尿量分别为（1．61±0．13）、（1．66±0．16）mL／h，均明显低于正常对照组[（6，06±0．18）mL／h，P〈0．01]。结论模拟海上颠簸刺激，可明显加重严重烧伤家兔休克及肾脏损害。

Objective To investigate the effect of stimulation of toss simulated at sea on shock in severe burn rabbits. Methods One hundred and thirty-two rabbits were randomly divided into normal control group （ NC group, n = 6） , toss group （ T group, with treatment of continuous toss, n = 42 ） , burn group （ B group, with treatment of burn, n = 42 ） , burn and toss （ BT group, with treatment of continuous toss after burn, n =42）. The level of Cr, BUN, HCT and LA from blood samples in T,BT,B groups were observed at 2,6, 8,12,24,36,48 post treatment hour（PTH）. The changes in urinary volume was measured during 48 PTH. The histopathologic changes in kidney were observed at above-mentioned time points. The above indices in NC group were also observed. Results The mean urinary volume in B group during the first and second 24 PTH was （2.59 ±0. 23） and （2.86 ±0.29）mL/h,while that in BT group was（ 1.61 ±0.13） and （ 1.66 ± 0. 16） mL/h respectively ,which were all lower than those in NC group（ 6.06 ± 0. 18 mL/h, P 〈 0.01 ）. The levels of HCT and LA in BT group were obviously higher than those in B group at each time point. The levels of Cr and BUN in BT group at 24,36,48 PTH were significantly higher than those in B group. The histopathologieal observation showed the capillary vessels and mesenchymal cells of kidney glomerulus were con- gestive, epithelial cells in kidney tubules were swollen. The infiltration degree of inflammatory cells in kidney tubule ,and the pathological changes of erythrocyte cast in BT group were more serious than those in B group. Conclusion The toss simulyted at sea can significantly aggravate shock and the renal damages in severe burn rabbits.