Pathophysiological analysis of third degree burn and efficacy of total escharectomy in super early phase of burn injury

三度烧伤病理生理分析及烧伤超早期全焦痂切除术的疗效

基本信息

批准号：
04670750
负责人：
SHINOZAWA Yotaro
金额：
$ 1.41万
依托单位：
Keio University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1992
资助国家：
日本
起止时间：
1992 至 1994
项目状态：
已结题

项目摘要

The efficacies of super early phase total escharectomy and mediator modulation on survival rate and oxygen radical product, which was considered to associate with organ dysfunction, were studied. 1.Effect of super early phase total escharectomy on survival rate Survival rates were as followed ; 43% (3/7) in non-escharectomy, 25% (1/4) in escharectomy alone, 50% (1/2) in escharectomy and allograft and 100% (2/2) in escharectomy and direct suture closure. Super early phase escharectomy did not expand the life span of 30% third degree burn rats, unless the excisioned wound was not properly managed. 2.Effect of super early phase total escharectomy and mediator modulation oxygen radical product Plasma malondialdehyde (MDA) level at two hours after burn was not changed by super early phase total escharectomy. Mediator modulation by aspirin (50,100,200 mg/kg) intra peritoneal administration immediately after burn lowered the plasma MDA levels in any dose aspirin administration groups. 3.Effec … More t of super early phase total escharectomy and mediator modulation on eicosanoidsSuper early phase total escharectomy lowered plasma levels of thromboxane (Tx) B2 and 6keto prostaglandin (PG) F1 alpha, and aspirin lowered TxB2 levels in dependence on administered aspirin dose. TxB2/6ketoPGF1 alpha ratio was lowest in 50 mg/kg aspirin administered group, and this ratio was lower in total escharectomy subgroup compared with that in non-eschaectomy subgroup in 0,100,200 mg/kg aspirin administered groups.Conclusion ; 1.Super early phase total escharectomy in 30% third degree burn reduced vasoconstrictive and platelet aggregative mediator TxA2 production, and 50 mg/kg intra peritoneal administration of aspirin lowered TxA2/PGI2 ratio. PGI2 serves for vasodilatation and inhibits platelet aggregation. So super early phase total escharectomy and mediator modulation by 50 mg/kg administration of aspirin were considered useful to maintain the microcirculation in animal with deep degree burn. 2.For the better prognosis in super early phase escharectomy group, proper wound care for excised burned wound was considered inevitable. Less

研究了超早期全焦痂切除术和介质调节对存活率和氧自由基产物的功效，氧自由基产物被认为与器官功能障碍有关。 1.超早期全焦痂切除术对存活率的影响存活率如下：非切痂术中 % (3/7)，仅切痂术中 25% (1/4)，切痂术和同种异体移植术中 50% (1/2) 100％（2/2）的切痂和直接缝合闭合，超早期切痂并不能延长30％三度烧伤大鼠的寿命，除非切除的伤口没有得到妥善处理。 2.超早期全切痂的效果。超早期全焦痂切除术未改变烧伤后两小时的血浆丙二醛（MDA）水平。烧伤后立即腹腔注射阿司匹林（50,100,200 mg/kg）可降低任何剂量阿司匹林给药组的血浆 MDA 水平。 3. 超早期全焦痂切除术和类二十烷酸介质调节的效果超早期全焦痂切除术降低了血浆 MDA 水平。血栓素 (Tx) B2 和 6 酮前列腺素 (PG) F1 α 和阿司匹林降低TxB2水平依赖于施用的阿司匹林剂量，在50 mg/kg阿司匹林施用组中最低，并且与0,100,200 mg/kg阿司匹林施用组中的非切痂亚组相比，该比值在全切痂亚组中较低。 .结论；1.超早期全焦痂切除术治疗30%三度烧伤可减少血管收缩和血小板聚集介质 TxA2 的产生，腹腔内给予 50 mg/kg 阿司匹林可降低 TxA2/PGI2 比例，从而起到血管舒张作用并抑制血小板聚集，因此考虑超早期全切痂和通过 50 mg/kg 阿司匹林给药进行介质调节。有助于维持深度烧伤动物的微循环。2.有利于超早期的更好预后。切痂组，对于切除烧伤创面的适当护理被认为是不可避免的。