摘要
目的 观察卡巴胆碱对50%总体表面积（TBSA）Ⅲ度烧伤早期口服补液效果的影响.方法 Beagle犬17条,先期行颈动、静脉、胃及膀胱置管,24 h后用凝固汽油燃烧造成50%TBSAⅢ度烧伤.随机分为不补液组、胃内补液组和胃内补液＋卡巴胆碱组.伤后第1个24 h不补液组无治疗,其余2组于伤后30 min开始经胃内输注葡萄糖-电解质液或葡萄糖-电解质液复合卡巴胆碱（20 μg/kg）.第1个24 h补液量为4 ml·kg^-1·%TBSA^-1;伤后24 h起各组动物均实施静脉补液,至72 h处死动物.测定两胃内补液组伤后8 h内胃排空率,各组72 h内平均动脉压（MAP）、心输出量（CO）、尿量、血浆肿瘤坏死因子（TNF）-α含量以及伤后72 h脏器组织一氧化氮合酶（NOS）活性变化.结果 伤后3组MAP、CO、尿量及胃排空率均显著降低,血浆TNF-α含量显著增高.两胃内补液组MAP和CO高于不补液组;胃内补液＋CAR组CO和胃排空率伤后4 h起显著高于胃内补液组（P〈0.01）,伤后24 h尿量也显著多于胃内补液组,伤后2、4和8 h血浆TNF-α含量以及伤后72h心、肝和空肠组织NOS活性显著低于胃内补液组（P〈0.01或P〈0.05）.结论 卡巴胆碱能提高50%TBSA烧伤早期口服补液的复苏效果,其作用机制可能与促进胃排空和减轻炎症反应有关.
Objective To investigate the effect of carbachol on early oral fluid resuscitation of a 50% total body surface area （TBSA） burn in dogs. Methods Seventeen Beagle dogs were surgically pre-pared for cannulation of carotid artery,jngular vein ,gastric and bladder,and 24 h later they were subjected to a 50% TBSA full-thickness flame injury. The dogs were randomized to three groups in the first 24 h after burn：non-resuscitation （NR group）, gastric resuscitation with glucose-electrolyte solution （GES group）, and gastric resuscitation with GES containing 20 μg/kg of carbachol （GES/CAR group）. The delivery rate of GES was 4 ml/kg of fluid per 1% TBSA bum during the first 24 h. In the second 24 h all dogs received IV fluid resuscitation. At the end of 72 h-period experiment,the mortality was recorded. Gastric emptying rote in the first 8 h was determined in two gastric resuscitation groups. Changes in homodynamics, cardiac output （CO） urinary output,plasma level of tumor necrosis factor-alpha （TNF-α） during the period of 72 h, and activity of nitric oxide synthase （NOS） of organ tissues at 72 h after bum were also determined. Results The levels of mean arterial pressure （MAP） ,CO,urinary output and the rate of gastric emptying were markedly rdeuced, and the contents of TNF-α obviously elevated in all three groups compared with those before burn injury. The levels of MAP and CO in two gastric infusion groups were significantly in-creased as compared with those in NR group. The levels of CO and the rate of gastric emptying were signifi-cantly increased in GES/CAR group as compared with those in GES group from 4 h after burn （P〈0.01）. Urinary output was increased in GES/CAR compared to that in GES group from 24 h post burn （P〈 0.01）. GES/CAR group showed lower TNF-α at 2 h,4 h ,8 h and NOS levels at 72 h than CES group （P〈 0.05 or P〈0.01） after injury. Conclusion Carbachol efficiently improved the resuscitative effects of oral resuscitation of 50% TBSA bum,which may be related to their effects of promoting gastric emptying and of attenuating systematic inflammation.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2010年第2期199-201,共3页
Chinese Journal of Experimental Surgery
基金
军队十一五医学科研计划专项课题（06Z055）
