延迟快速苏醒对犬烧伤后早期肾功效的影响.docVIP

延迟快速复苏对犬烧伤后早期肾功能的影响 延迟快速复苏对犬烧伤后早期肾功能的影响 更新日期：2011-06-16 闫柏刚　杨宗城　黄跃生　刘志远　傅琼芳　何保斌　 　　【摘要】　目的　探讨烧伤后延迟复苏情况下，快速补液对伤后早期肾脏功能的影响。　方法 利用犬40% TBSA Ⅲ度烫伤模型，24只犬被随机分为烧伤对照组、延迟快速补液组和延迟均匀补液组进行补液，观察伤前、伤后2，6，8，12，24，36和48 h血浆尿素氮(Bun)、肌酐(Cr)、内皮素(ET)和血管紧张素Ⅱ(ATⅡ)等指标的变化。　结果　烧伤后各组血浆Bun、Cr、ET和ATⅡ逐渐升高，至伤后2～6 h即显著高于伤前并继续升高，但补液两组上升幅度明显低于烧伤对照组，而快速补液组烧伤8 h以后（快速补液后）血浆Bun、Cr、ET、ATⅡ均显著低于均匀补液组。烧伤后各组尿量逐渐减少，补液后尿量增加，其中快速补液组尿量显著多于均匀补液组。　结论　在烧伤后延迟复苏情况下，快速补液可以减轻肾功能的损害。 　　【关键词】　烧伤；　休克；　复苏术；　肾功能试验 Effect of delayed rapid fluid resuscitation on renal function at the early stage after burn YAN Baigang, YANG Zongcheng, HUANG Yuesheng, et al. Burn Research Institute, Southwestern Hospital, The Third Military Medical University, Chongqing 400038, China 　　【Abstract】　 Objective 　To investigate the effect of rapid fluid replacement on renal function in delayed resuscitation after burn. 　Methods　The dogs inflicted with 40%TBSAⅢdegree scalding were randomly divided into 3 groups: a burn control group (C group), a delayed rapid fluid replacement group (R group) and a delayed homogeneous fluid replacement group (H group). The blood urea nitogen(Bun), creatinine(Cr), urine volume, endothelin(ET) and angiotensin II(AII) were detected before burn and at 2, 6, 8, 12, 24, 36, 48 h postburn. 　Results　 The blood urea nitogen(Bun), creatinine(Cr), endothelin(ET) and angiotensin II(AII) markedly increased 2～6 h postburn, but the parameters in R and H groups were obviously lower than that in C group after fluid resuscitation, and the parameters of R group were obviously lower than that in H group at 8 h after burn (after rapid fluid replacement). The urine volume of each group decreased post burn, but the urine volume of R and H groups increased after fluid resuscitation, the urine volume of R group was obviously higher than that in H group. 　Conclusions 　In delayed resuscitation after burn, rapid fluid replacement is considered to have effect in protecting renal function. 　　【Key words】　 Burn;　Shock;　Resuscitation;　Ren