采用数学模型估算休克期切痂烧伤病人休克期补液量  

A mathematical model estimating the amount of fluid supplement in burn patients with escharectomy during shock stage

作　　者：贾晓明[1] 纪晓峰[1] 柴家科[1] 郭振荣[1] 盛志勇[1] 

机构地区：[1]解放军第304医院烧伤研究所临床部,北京100037

出　　处：《感染．炎症．修复》2001年第1期21-24,共4页Infection Inflammation Repair

基　　金："九五"军队科研基金(97H30)

摘　　要：目的:根据回顾性资料,采用多重回归的统计方法拟合成数学模型对临床休克期切痂围手术期补液量进行预测性分析。方法:收集1991～1998年30例施行休克期切痂的大面积烧伤病人资料,根据病人入院时的临床和实验室检查选取多种观察变量对休克期切痂手术前和手术后补液量进行多重回归,拟合回归方程并进行统计学检验。同时用第三军医大学烧伤补液公式计算手术前补液量与回归方程所计算的补液量进行比较。结果:通过回归方程,可以根据烧伤病人入院时的烧伤面积、年龄、心率、尿量、血红蛋白和红细胞压积预测病人休克期切痂前的补液量,同时根据术前补液量和切痂时间预测术后补液量。根据回归方程计算的补液系数为1.757,大于第三军医大学公式,与我科临床目前使用的系数1.8相近。结论:采用回顾性的资料估算休克期切痂病人休克期内的补液量,考虑了与病人循环状况有密切关系的烧伤面积之外的其他因素,如尿量、血红蛋白和红细胞压积等,便于更全面的预测病人的液体需要量,有助于临床医生掌握休克期切痂病人的补液量。Objective: To estimate the amount of fluid supplement in burn patients with escharectomy during shock stage by multiple regression mathematical model through analysing retrospective data. Methods: The clinical data of 30 major burn patients receiving escharectomy during shock stage from 1991 to 1998 were collected. Various variables selected from the clinical and laboratory parameters in patients were gathered to process the multiple regression to estimate the fluid supplement before operation and after operation. At the same time the fluid supplement calculated by the formula of the Third Military Medical Collage was compared to that of our calculation. Results: According to our calculation, the amount of fluid supplement in burn patients with shock stage escharectomy could be estimated by the burn area, heart rate, urine amount, hemoglobin and HCT of patients. The coefficient calculated was 1. 757, which was higher than that of the formula of the Third Military Medical Collage and close to 1.8 in our clinical application. Conclusion: The advantage of using regressive statistics to estimate the amount of fluid supplement in burn patients undergoing shock stage-escharectomy is to put integrated factors related to the circulatony state of burn patients into consideration. Such model can estimate the amount of fluid supplement more comprehensively and help doctors manage the fluid supplement in burn patients during shock stage.

关 键 词：数学模型 烧伤 休克期 切痂手术 

分 类 号：R64[医药卫生—外科学]