中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
10期
785-788
,共4页
邢楠%周建军%陈炯%苏国良%施剑武%池章章
邢楠%週建軍%陳炯%囌國良%施劍武%池章章
형남%주건군%진형%소국량%시검무%지장장
烧伤%休克%模型,动物%猪,雏型
燒傷%休剋%模型,動物%豬,雛型
소상%휴극%모형,동물%저,추형
Burns%Shock%Model,animal%Swine,miniature
目的 制作小型猪重度烧伤休克的稳定模型.方法 按随机数字表法将12只4～6月龄雌性广西巴马小型猪分为A、B两组各6只,静脉麻醉等处理后,以凝固汽油燃烧制作占体表总面积(TBSA) 40％的皮肤烧伤(A组45 s,B组50 s),肉眼与组织病理学检查判断创面深度；在烧伤后2h进行复苏,记录每小时心率、血压、尿量、中心静脉压(CVP)、肺动脉契压(PAWP)及烧伤前和烧伤后第1、2个24h液体实际输入量,根据伤后2h的休克指数判断休克状态.结果 A、B两组均完成烧伤模型制作,烧伤创面分别呈深Ⅱ、Ⅲ度改变.烧伤后2h与烧伤前比较,两组猪均呈现心率加快[(111 ±6)比(74±9)、(119±13)比(75±13)次/min]、尿量减少[(0.99±0.06)比(1.45±0.05)、(0.82 ±0.04)比(1.47 ±0.06)ml·kg-1 h-1]、CVP与PAWP下降,差异均有统计学意义(均P＜0.05)；而血压无显著变化[(120 ±6/93±9)比(120 ±6/94±6)、(121±15/90±11)比(124±10/91±8)mm Hg],差异均无统计学意义(均P＞0.05)；烧伤后48 h内血压均值组间差异均无统计学意义(均P ＞0.05).A、B组烧伤后第1个24 h复苏液体量分别为(1.53±0.05)、(1.66 ±0.10)ml·kg-1·1％-1TBSA,差异有统计学意义(P＜0.05),两组液体进出量比值差异均无统计学意义(P＞0.05)；烧伤后第2个24 h的复苏液体量分别为(0.65±0.16)、(0.69±0.17)ml·kg-1·1％-1 TBSA,差异无统计学意义(P＞0.05),液体进出量比值差异无统计学意义(P＞0.05).A、B组在2h时相点的休克指数分别为0.92±0.07、1.00 ±0.16,差异无统计学意义(P＞0.05).结论 本法制作的小型猪重度烧伤休克的模型稳定可靠.
目的 製作小型豬重度燒傷休剋的穩定模型.方法 按隨機數字錶法將12隻4～6月齡雌性廣西巴馬小型豬分為A、B兩組各6隻,靜脈痳醉等處理後,以凝固汽油燃燒製作佔體錶總麵積(TBSA) 40％的皮膚燒傷(A組45 s,B組50 s),肉眼與組織病理學檢查判斷創麵深度；在燒傷後2h進行複囌,記錄每小時心率、血壓、尿量、中心靜脈壓(CVP)、肺動脈契壓(PAWP)及燒傷前和燒傷後第1、2箇24h液體實際輸入量,根據傷後2h的休剋指數判斷休剋狀態.結果 A、B兩組均完成燒傷模型製作,燒傷創麵分彆呈深Ⅱ、Ⅲ度改變.燒傷後2h與燒傷前比較,兩組豬均呈現心率加快[(111 ±6)比(74±9)、(119±13)比(75±13)次/min]、尿量減少[(0.99±0.06)比(1.45±0.05)、(0.82 ±0.04)比(1.47 ±0.06)ml·kg-1 h-1]、CVP與PAWP下降,差異均有統計學意義(均P＜0.05)；而血壓無顯著變化[(120 ±6/93±9)比(120 ±6/94±6)、(121±15/90±11)比(124±10/91±8)mm Hg],差異均無統計學意義(均P＞0.05)；燒傷後48 h內血壓均值組間差異均無統計學意義(均P ＞0.05).A、B組燒傷後第1箇24 h複囌液體量分彆為(1.53±0.05)、(1.66 ±0.10)ml·kg-1·1％-1TBSA,差異有統計學意義(P＜0.05),兩組液體進齣量比值差異均無統計學意義(P＞0.05)；燒傷後第2箇24 h的複囌液體量分彆為(0.65±0.16)、(0.69±0.17)ml·kg-1·1％-1 TBSA,差異無統計學意義(P＞0.05),液體進齣量比值差異無統計學意義(P＞0.05).A、B組在2h時相點的休剋指數分彆為0.92±0.07、1.00 ±0.16,差異無統計學意義(P＞0.05).結論 本法製作的小型豬重度燒傷休剋的模型穩定可靠.
목적 제작소형저중도소상휴극적은정모형.방법 안수궤수자표법장12지4～6월령자성엄서파마소형저분위A、B량조각6지,정맥마취등처리후,이응고기유연소제작점체표총면적(TBSA) 40％적피부소상(A조45 s,B조50 s),육안여조직병이학검사판단창면심도；재소상후2h진행복소,기록매소시심솔、혈압、뇨량、중심정맥압(CVP)、폐동맥계압(PAWP)급소상전화소상후제1、2개24h액체실제수입량,근거상후2h적휴극지수판단휴극상태.결과 A、B량조균완성소상모형제작,소상창면분별정심Ⅱ、Ⅲ도개변.소상후2h여소상전비교,량조저균정현심솔가쾌[(111 ±6)비(74±9)、(119±13)비(75±13)차/min]、뇨량감소[(0.99±0.06)비(1.45±0.05)、(0.82 ±0.04)비(1.47 ±0.06)ml·kg-1 h-1]、CVP여PAWP하강,차이균유통계학의의(균P＜0.05)；이혈압무현저변화[(120 ±6/93±9)비(120 ±6/94±6)、(121±15/90±11)비(124±10/91±8)mm Hg],차이균무통계학의의(균P＞0.05)；소상후48 h내혈압균치조간차이균무통계학의의(균P ＞0.05).A、B조소상후제1개24 h복소액체량분별위(1.53±0.05)、(1.66 ±0.10)ml·kg-1·1％-1TBSA,차이유통계학의의(P＜0.05),량조액체진출량비치차이균무통계학의의(P＞0.05)；소상후제2개24 h적복소액체량분별위(0.65±0.16)、(0.69±0.17)ml·kg-1·1％-1 TBSA,차이무통계학의의(P＞0.05),액체진출량비치차이무통계학의의(P＞0.05).A、B조재2h시상점적휴극지수분별위0.92±0.07、1.00 ±0.16,차이무통계학의의(P＞0.05).결론 본법제작적소형저중도소상휴극적모형은정가고.
Objective To report a novel method of establishing a stable shock model of swine.Methods A total of 12 Guangxi BA-MA female miniature swines (aged 4-6 months) into A and B groups according to a random number table.Total body surface area (TBSA) was calculated according to the Meeb-Rubner formula.After intravenous anesthesia and other steps,solidified gasoline was used as burns material to establish TBSA 40％ skin burn (Group A:45 s,Group B:50 s).Burn depth by was judged by visual and histopathological examination.Fluid resuscitation was instituted at 2 h post injury.At the same time,the hourly and pre-injury data of heart rate (HR),blood pressure (BP),urinary volume,central venous pressure (CVP) and pulmonary arterial wedge pressure (PAWP) were recorded.The actual input quantities of fluid resuscitation were assessed at the 1st and 2nd 24 h post injury.And shock condition was estimated by shock index at 2 h post injury.Results All miniature swines were successfully modeled without any mortality.The burn wound observed by visual examination and light microscope showed that Group A was of deep Ⅱ burn and Group B Ⅲ bum.Compared with the pre-injury data,HR (111 ± 6 vs 74 ± 9,119 ± 13 vs 75 ± 13 beats/min) increased,urinary volume (0.99 ±0.06 vs 1.45 ±0.05,0.82 ±0.04 vs 1.47 ±0.06 ml · kg-1 · h-1),CVP and PAWP decreased at 2nd 24 h post-injury in two groups (P ＜0.01,P＜0.05).But the changes of BP (120±6/93±9 vs 120±6/94±6,121±15/90±11 vs 124±10/91 ± 8 mm Hg) had no statistical significance (P ＞ 0.05).The average value of HP in 48 h post-injury had no statistical significance in two groups (P ＞ 0.05).The recovery liquid quantity in the first 24 h of Group B (1.66 ±0.10 ml · kg-1 · 1％-1 TBSA) was significantly more than Group A (1.53 ±0.05 ml ·kg-1 · 1％-1TBSA) (P ＜ 0.05).The ratio between liquid input and output of Groups A and B showed that the comparison had no statistical significance (P ＞ 0.05).In the second 24 h post-injury,the recovery liquid quantity (0.69 ±0.17,0.65 ±0.16 ml · kg-1 · 1％-1TBSA) and the ratio between liquid in and out (1.48 ± 0.28,1.52 ± 0.27) ％ between Groups A and B had no statistical significance (P ＞ 0.05).The shock index at 2 h post-injury showed that Groups A and B were in shock compensatory period(0.92 ±0.07) and mild shock state (1.00 ± 0.16) respectively (P ＞ 0.05).Conclusion Such a shock model is stable and dependable.
