Anisodamine restores bowel circulation in burn shock
Anisodamine restores bowel circulation in burn shock
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DOI：
10.1016/s0305-4179(96)00086-1
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发表时间：
1997-03-01
期刊：
影响因子：
2.7
通讯作者：
He, LX
中科院分区：
文献类型：
--
作者：
Sheng, CY;Gao, WY;He, LX
在一组8例平均65.3 +/- 17.4% TBSA烧伤（范围50- 90% TBSA），平均43.5 +/- 18.9% TBSA全层损伤的brim患者中，结果表明，在积极的液体复苏后12小时，整体低血容量的证据消失了。48 h时胃pHi值仍低于正常水平。由于长时间的肠供氧不足可能导致肠黏膜屏障功能受损，进而可能发生内源性内毒素血症，因此尽早纠正肠道缺氧是很重要的。既然肠壁的灌注不足是由于选择性血管收缩造成的？对于肠系膜血管系统，逻辑上表明血管扩张剂的使用是合理的。山莨菪碱是一种抗胆碱能药物，然后给予6名烧伤患者，烧伤大小和补液量与对照组的8名患者相当。结果表明，胃pHi在损伤后48小时内恢复正常。血浆内毒素和肿瘤坏死因子的含量在72小时后显著低于对照组。总之，我们认为山莨菪碱可能是烧伤休克复苏方案的一种有价值的辅助手段，因此，它是一种有希望的药物，可以减轻由于低血容量引起的内脏血管收缩引起的内源性内毒素血症。该药的缺点是服用后轻度腹胀和心动过速。(C) 1997 Elsevier Science Lid for ISBI
In a group of eight brim patients with a mean of 65.3 +/- 17.4 per cent TBSA burn injury (range 50-90 per cent TBSA), accompanied by a mean of 43.5 +/- 18.9 per cent TBSA full-thickness injury, it was shown that the evidence of global hypovolaemia had disappeared at 12 h after the injury following aggressive fluid resuscitation, while there was still a subnormal pHi of stomach at 48 h. As a prolonged period of inadequacy of oxygen delivery to the intestine might result in impairment of the intestinal mucosal barrier function, and then endogenous endotoxaemia might ensue, ii seems to be important to correct intestinal hypoxia as early as possible. Since the inadequate perfusion to the gut wall is due to selective vasoconstriction? of the mesenteric vasculature, logic dictates that the use of a vasodilator is in order. Anisodamine, an anticholinergic drug, was then given in six burn patients with comparable burn size and amount of fluid replenishment with the eight patients in the control group. It was clearly demonstrated that gastric pHi returned to normal before 48 h after injury. Plasma endotoxin and TNF contents were measured, and they were significantly lower than control values after 72 h. In conclusion, it is believed that anisodamine might be a valuable adjunct to the resuscitation regime of burn shock, anti, therefore, a promising drug to abate endogenous endotoxaemia subsequent to splanchnic vasoconstriction due to hypovolaemia. The short-comings of the drug were a mild abdominal distention and tachycardia after its administration. (C) 1997 Elsevier Science Lid for ISBI.