休克期切痂植皮对小型猪烧伤后能量消耗的影响

Effect of escharectomy and skingrafting of minipigs during burn shock stage on postburn energy expenditure

目的观察贵州三系实验用小型猪正常及烧伤后静息能量消耗（ＲＥＥ）的变化规律及休克期切痂植皮是否对烧伤后ＲＥＥ产生影响。方法借助小型猪烧伤模型，应用代谢车面罩法测量单位时间内氧气消耗量、二氧化碳产生量及ＲＥＥ的变化。结果休克期切痴植皮组、非休克期切痴植皮组和单纯烧伤组伤后ＲＥＥ值均明显升高，但休克期切痴植皮组由于及时切痂植皮封闭创面，ＲＥＥ值在伤后９６ ｈ开始下降，并于伤后 １２ ｄ内明显低于非休克期切痴植皮组和单纯烧伤组，而后两组则仍保持了持续的高代谢状态。结论严重深度烧伤休克期切痂植皮可在一定程度上减轻机体的高代谢状态。

Objective To determine the changes in resting energy expenditure (REE) of minipigs in normal and postburn stage, and the effect of escharectomy during burn shock stage on energy expenditure. Methods Swine model with 35% TBSA Ⅲ degree flame burn was used. Eighteen male minipigs were randomly divided into three groups: control group, escharectomy during burn shock stage group and escharectomy after burn shock stage group. REEs were monitored by means of Cardiorespiratory Diagnostic Systems (Medical Graphics Corporation, USA). Results The levels of REE in escharectomy during burn shock stage group decreased early and were obviously lower than those in other two groups. sion.These findings suggest that escharectomy and skin grafting during burn shock stage could ameliorate hypermetabolism in major burn patients.