摘要
目的通过测定 TBSA30％Ⅲ度烧伤大鼠早期手术后肝血流量的变化,了解早期手术对肝脏血液灌流的影响。方法 Wistar 雄性大鼠34只,分为4组:烧伤组(A 组),输液组(B 组),早期手术组(C 组),正常对照组(D 组)。输液组经股静脉插管输入乳酸林格氏液;早期手术组于立即补液的同时行切痂同种异体植皮术。各组于伤后0,0.5,1,2,3,6,12和24小时,应用氢清除法测定肝血流量。结果 A 组与 B 组伤后均出现肝血流量显著下降,B 组直至伤后24小时肝血流量才恢复正常,而 C 组伤后肝血流量保持相对稳定,与正常对照组比较无显著意义。结论严重烧伤后立即液体复苏尚不足以维持有效的肝脏血流灌流,烧伤后早期手术尽早地去除焦痂组织,对改善肝血流量具有重要作用。
Objective To evaluate the effects of early burn wound excision and skin grafting on the hepatic blood flow(HBF)in comparison with infusion treatment after severe burn injury in rats. Methods Thirty-four male Wistar rats were allocated to four groups of eight to ten animals.The com- mon femoral vein and midline laparotomy for placing a platinum electrode on the surface of the liver were performed under pentobarbital anesthesia.After 24 hours,the rats underwent different treat- ment,as follows.The burn group(A group,n=8)received a burn injury only.The burn+infusion group(B group,n=8)was infused with lactated Ringer's solution after being burned.The burn+infu- sion+early excision group(C group,n=8)underwent escharectomy and allografting with fluid resusci- tation after being burned.The sham group(D group,n=10)received anesthesia and underwent a sham burn procedure.The HBF was measured at 0,0.5,1,2,3,6,12 and 24 hours postburn in each group us- ing the hydrogen gas clearance method.Results A significant decrease in HBF was found in both the A and B groups after burn.On the other hand,the C group showed similar changes in HBF as the D group.Conclusion The HBF decreases postburn even with continuous fluid resuscitation,but it is maintained stable by early wound excision and allo-skin grafting with fluid resuscitation.These findings indicated that early excision is helpful in stabilizing the HBF without further aggravating the hepatic hemodynamic load.
