延迟快速血定安复苏对烫伤犬血液动力学及流变学的影响

Effects of delayed rapid resuscitation with Gelofusine on blood dynamics and hemorheology during thermal injury in dogs

目的 探讨延迟快速血定安复苏对烫伤犬血液动力学及流变学的影响。方法 复制 40 %Ⅲ度犬烫伤延迟快速复苏 (伤后 6h)模型 ,实验分为烫伤不补液组 (BC)、血浆补液组 (DP)、血定安补液组 (DG) ,观察其股动脉血压 (BP)、心输出量(CO) ,并检测血液粘度及红细胞聚集指数。结果 (1)烫伤对照组伤后 12～ 36h内动物全部伤亡 ,DP、DG两组均存活 48h以上 ;(2 )烫伤后各组动物BP、CO均显著下降 ,DP、DG两组补液后两指标均有明显回升 ,伤后 8、2 4、36、48hCO与伤前无明显差异 ,但股动脉血压除伤后 8h外其余各时相点均显著低于伤前水平 ;(3)烫伤后高、低切变率下血液粘度及红细胞聚集指数均显著升高 ,DP、DG两组补液复苏后都有所恢复 ,但 48h内均不能达到伤前水平 ;(4)DP、DG两组各相应时相点BP、CO变化无明显差别 ,伤后 8hDG组血液粘度及红细胞聚集指数低于DP组。结论 延迟快速血定安复苏能替代血浆有效改善烫伤犬血液动力学及流变学状况 ,降低动物死亡率 ;但烫伤延迟复苏时应加大补液量 ,并于伤后 8～ 2 4h内补入。

Objective To study the effects of delayed rapid resuscitation with Gelofusine on hemodynamics and hemorheology during scalding injury in dogs Methods 24 dogs were inflicted with 40%TBSA full thickness scalding and randomized equally into the burn control group(BC),delayed rapid plasma resuscitation group(DP) and delayed rapid gelofusine resuscitation group(DG) BP,CO,blood viscosity,erythrocyte clumping index were determined before scalding and in the 2nd,6th,8th,12th,24th,36th and 48th hour postscalding Results ①Dogs of BC died within 36 hours,but dogs of DP and DG survived at least 48 hours ②After scalding,BP and CO of each group were gradually decreased,meanwhile,blood viscosity and erythrocyte clumping index increased After rapid resuscitation,BP,CO,blood viscosity and erythrocyte clumping index were all improved Except for CO,they didn't come back to the level of prescalding within 48 hours There was noobvious difference in BP and CO at al corresponding time point between DP and DG But blood viscosity and erythrocyte clumping index of DG were lower than that of DP in the 8th hour postburn Conclusions Delayed rapid resuscitation with Gelofusine replacing plasma could improve the blood dynamics and hemorheology during thermal injury But the volume of infusion fluid ought to be increased and infused within 8～24 hours postburn,when resuscitation was delayed