血浆代用品(血定安)应用于烧伤休克复苏的实验研究

摘要

目的：验证血浆代用品(血定安)在烧伤休克液体复苏中的疗效。方法：利用犬40％TBSAⅢ度烫伤模型，24只狗随机分为烧伤对照组(C)、血浆复苏组(P)和血定安复苏组(G)，观察伤前、伤后2、6、8、12、24、36和48 h心输出量(CO)、氧供(DO2)、氧耗(VO2)、血液粘度，肌球蛋白轻链1(MLC1)和血清总蛋白等指标的变化。结果：①复苏后CO、DO2、VO2显著上升，MLC1明显下降，血定安组与血浆组相比无显著差异。②复苏后血液粘度下降，快速补液时，血安定组显著低于血浆组。③伤后血清总蛋白呈下降趋势，其中血定安组显著低于血浆组。结论：烧伤后休克复苏中，血浆代用品(血定安)与血浆的疗效相近，可在烧伤休克早期救治中广泛应用。%Objective:To investigate the effects of plasma substitute(Gelofusion)on fluid resuscitation during shock in burned dogs.Methods:The dogs inflicted with 40％ TBSA Ⅲ degree scalding were randomly divided into 3 groups:thermal injury control group (C group),plasma resuscitation group(P group)and Gelofusion resuscitation group(G group).The cardiac output (CO),oxygen delivery(DO2),oxygen consumption(VO2),blood viscosity,myosin light chain 1(MLC1)and serum total protein were detected before injury and at 2,6,8,12,24,36,48 h after injury.Results:①After fluid replacement,the lever of CO,DO2 and VO2 were gradually increased,the lever of MLC1 markedly decreased,but there were no significant differences between G group and P group.②After resuscitation,blood viscosity markedly decreased,that of G group obviously lower than P group on rapid fluid replacement.③After scalding,serum total proteins were decreased,that of G group obviously lower than P group.Conclusion:In the resuscitation of burn shock,the effects of Gelofusion is similar to plasma.Gelofusion could be a fairly good plasma substitute for extensive application on the management of burn shock during the early stage.