快速输液对严重烧伤早期多脏器功能衰竭预防的动物实验研究

Prevention of multiple organ failure in early stage of severe burns with immediate fast fluid infusion in dogs

本文证明严重烧伤立即输液对预防烧伤早期MOF有利;延迟均匀输液则不利;而延迟快速输液可部分预防MOF发生。其表现为立即和延迟快速输液组的SV、SI、LVSWI、RVSWI、FAP维持在伤前值的50％以上,并逐渐恢复接近伤前值。PAWP小于1.3kPa,ALT、LDT增加没有超过伤前值的2倍。DB、TB、UN、Cr、PaO_2、P(A-a)O_2、MDA、RCR、ADP/O和ATP变化不明显。血培养阳性率、死亡率和MOF发生率低,病理改变轻。

Fifty percent TBSA third degree burns was inflicted to 24 dogs and they were treated with immediate fluid infusion (8 dogs),delayed conventional infusion (n=8),and delayed fast infusion (n=8),It was found that in the immediate and delayed fast infusiong groups,strike volume,strike index, left ventricular strike work index,right ventricular strike index and femoral arterial pressure were maintained at a level more than 50% of the normal and were gradually restored.Their pulmonary artery wedge pressure was larger than 1.3 kPa.ALT and LDH were increased but never exceeded the preburn level.DB,TB,UN,Cr,PaO2,P(A-a)O2 were maintained in the normal range.MDA RCR,ADP/O,ATP,positive blood culture rate,mortality rate and morbility of multiple organ failure were all lower than those of the delayed conventional infusion group.It is believed that in the early stage of burn injury,the development of multiple organ failure can prevented effectively with immediate infusion and partially with delayed fast infusion while delayed conventional infusion exerts no protection at all.