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目的:通过烧伤后早期口服液体复苏(EOFR)与静脉液体复苏的对比研究,探讨EOFR对烧伤休克时循环和组织灌流的影响,评价其对烧伤休克的复苏效果。方法:选择32只杂种犬复制30%体表面积(TBSA)Ⅲ度烧伤模型,并随机分为不复苏对照(NR)组、口服WHO ORS液(WOR)组、口服林格氏液(LOR)组、林格氏液静脉复苏对照(LVR)组,检测不同时间点平均动脉压(MAP)、胃黏膜pH值、24小时尿量及病死率等指标。结果:WOR组和LOR组的MAP、胃黏膜pH值、24小时尿量较LVR组显著降低,但明显高于NR组(P<0.05,P<0.01)。NR组24、48小时病死率为62.5%和100.0%,明显高于WOR组、LOR组及LVR组(P<0.01)。结论:EOFR可有效改善30%TBSAⅢ度烧伤的循环指标,恢复重要脏器血液灌流,部分替代静脉液体复苏。
OBJECTIVE: To investigate the effect of EOFR on the circulation and tissue perfusion during burn shock and to evaluate its effect on the recovery of burn shock by comparative study of early oral liquid resuscitation (EOFR) and venous fluid resuscitation after burn injury. Methods: Twenty-three mongrel dogs were randomly divided into three groups: the non-resuscitation control (NR) group, the oral WHO ORS solution (WOR) group and the oral Ringer’s solution (LOR) group , Ringer’s solution venous recovery control (LVR) group. The mean arterial pressure (MAP), gastric mucosal pH, 24-hour urine output and mortality at different time points were measured. Results: The MAP, gastric mucosal pH value and 24-hour urinary volume in WOR group and LOR group were significantly lower than those in LVR group, but significantly higher than those in NR group (P <0.05, P <0.01). In the NR group, the mortality rates at 24 h and 48 h were 62.5% and 100.0%, respectively, which were significantly higher than those in the WOR, LOR and LVR groups (P <0.01). Conclusion: EOFR can effectively improve the circulation index of 30% TBSA Ⅲ degree burn, restore the blood perfusion of vital organs and partially replace the recovery of venous fluid.