实验性苯酚皮肤烧伤创面洗消剂的选择

Selection of decontaminants for experimental phenol burn wounds

目的观察苯酚灼伤创面常用洗消剂的洗消效果。方法应用浓度为90％苯酚水溶液对成年雄性SD大鼠背部正中部位皮肤进行灼伤2min，分别使用清水、75％乙醇、聚乙二醇400（PEG400）、敌腐特灵（Diphoterine）4种洗消剂进行洗消15min，观察各组创面的变化，对比伤后24h各组皮肤灼伤深度及伤后6h血清总胆红素（TBIL）、肌酐（CREA）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、肌酸激酶（CK）、乳酸脱氢酶（LDH）6种常用脏器损伤指标变化。结果苯酚灼伤皮肤后敌腐特灵组洗消效果最好，皮肤及脏器损伤程度较轻，与清水组洗消的差异有统计学意义（P〈0．05）；75％乙醇组与PEG400组洗消效果相近，两组皮肤及脏器损伤情况类似，洗消效果均优于清水组。其中75％乙醇组的肌酸激酶与乳酸脱氢酶水平明显低于清水组，差异均有统计学意义（P〈0．05）。4种洗消剂中清水组洗消效果较差，创面最深，脏器损伤较重。结论苯酚灼伤后早期用清水洗消效果较差，而用敌腐特灵洗消创面能减轻苯酚灼伤深度及重要脏器损伤程度，洗消效果好。

Objective To investigate the effect of the decontaminants frequently used for phenol burn wounds. Methods The central part of the dorsal skin of adult male Sprague-Dawley rats were burned with 90% （W/V） phenol solution for 2 min, and water, 75% ethanol, polyethylene glycol 400 （PEG400）, and Diphoterine were applied for decontamination for 15 rain. The changes in wounds were observed, and the depth of skin bums at 24 hours after treatment and changes in six indicators of organ injuries, i.e., serum levels of total bilirubin （TBil）, creatinine （Crea）, alanine aminotransferase （ALT）, alanine aminotransferase（AST）, creatine kinase （CK）, and lactate dehydrogenase （LDH）, at 6 hours after treatment were compared.Results After phenol burns, the Diphoterine group had a significantly better effect and significantly lower degrees of skin and organ injuries compared with the water group （P〈0.05）. The effect of decontamination and degrees of skin and organ injuries were similar between the 75% ethanol group and the PEG400 group, and both groups had a better effect of decontamination compared with the water group ; the 75% ethanol group had significantly lower serum levels of CK and LDH than the water group （P〈0.05）. Among these four groups, the water group had the worst effect, the deepest wounds, and the most severe organ injuries. Conclusion After phenol burns, early decontamination with water has a poor effect, while Diphoterine can reduce the depth of phenol bums and the degrees of injuries of vital organs, and has a good effect of decontamination.