严重烧伤早期心肌损害机制及临床意义的再认识

Further understanding on myocardial damage in the early stage post severe burn and its clinical significance

众所周知，休克的发生主要与血容量、心脏动力、血管张力等3个因素密切相关。以往将严重烧伤休克期心功能减退的原因，主要归咎于烧伤后毛细血管通透性增加导致血容量减少或心肌抑制因子的作用。对于心脏动力和血管张力在休克发生中的作用，缺乏应有的认识和关注。大量临床实践表明,即使伤后立即按照补液公式进行复苏治疗，有时仍难以纠正烧伤休克。

A series of studies demonstrated that myocar- dial damage and cardiac dysfunction occurs immediately follow- ing severe burn, even before significant reduction in blood vol- ume due to increased capillary permeability. Such myocardial damage and cardiac dysfunction leads to cardiac deficiency, and it is a precipitating factor for burn shock and isehemie/hypoxie injury. In recent years, many experimental and clinical studies elucidated the pathogenesis and confirmed the clinical impor- tance of prevention and treatment of ＂ shock heart＂ in the early stage post severe burn.