重症烧伤早期输注高氧液及对血清丙二醛水平变化的影响  

The influence of hypertonic oxygen solution infusion on the change of serum malondialdehyde level in severe burn patients during the early posthurn stage

作　　者：段鹏[1] 雷晋[1] 赵志伟[1] 明志国[1] 成剑[1] 郝振明[1] 焦海梅[1] 张随发 刘丽[2] 郑晋英 

机构地区：[1]山西省烧伤救治中心烧伤科,太原030009 [2]山西省烧伤救治中心检验科,太原030009

出　　处：《中华损伤与修复杂志（电子版）》2007年第4期212-215,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨高氧液输注的安全性、有效性及对重症烧伤患者血清丙二醛水平的影响。方法选择伤后72h以内入院、烧伤体表总面积(total burns surface area,TBSA)在30%以上、伤前无严重疾患、年龄18～65岁的重症烧伤30例,随机分为治疗组及对照组,每组15例。两组均按"四早"方案治疗,在此基础上治疗组在静脉补液时以500 ml×4/24 h的高氧液代替等量的常规液体补入,对照组输注常规液体。两组均于输注高氧液前及输注后的24 h、48 h、72 h分别采集血标本,用比浊法测定血清丙二醛含量。并于采集血标本的同一时间点,记录各病例的一般情况,包括:体温、呼吸、心率,经股动脉采集动脉血送检血气分析。数据以±s表示,采用PEMS 3.1统计分析软件进行t检验。结果两组病例的一般情况:体温、呼吸、心率在输注高氧液前后的各时间点比较无差异(P>0.05);血气分析:PaO_2、SaO_2及血清丙二醛含量在输注高氧液前两组间比较无差异(P>0.05),输注高氧液后各时间点治疗组和对照组比较PaO_2、SaO_2提高(P<0.05),血清丙二醛含量降低(P<0.05)。结论在重症烧伤早期输注高氧液是安全的、有效的,可提高患者的PaO_2、SaO_2,迅速改善组织细胞缺血缺氧,并且可减轻严重烧伤早期的脂质过氧化反应,减轻氧自由基损伤。Objective To explore the safety and efficacy of the infusion of oxygen-enriched solution on severe burn patients and its influence on serum malondialdehyde （MDA） level in the patients during their early postburn stage. Methods Thirty severe burn patients aged 18 -65 years with TBSA more than 30% and being admitted within 72 PBHs and without previous severe diseases were enrolled in the study and were randomly divided into treatment and control groups with 15 cases in each group. The patients in both groups were all treated by ＂four early＂ program. In addition, 500 ml × 4 solution with hypertonic oxygen per 24 hours was intravenously infused instead of routine solution in treatment group, while routine solution was employed in the control group. Blood samples were harvested before and 24 h ,48 h and 72 h after the infusion of hypertonic oxygen solution in both groups. The serum content of MDA in the samples was determined by turbidimetry. Simultaneously, the general data of the patients, i.e. temperature （ T）, respiratory （ R）, heart rate （HR） were all recorded. The arterial blood was harvested for blood gas analysis. All the data were expressed as x^- ＋ s. PEMS3.1 statistical software was employed for the t test. Results There was no difference of the T, R and HR between the two groups of patients （ P 〉 0.05）. But the PaO2 and SaO2 were evidently higher in treatment group than those in control group （ P 〈 0.05 ） ; while the serum content of MDA in treatment group was obviously lower than that in control group （P 〈 0.05 ）. Conclusions It was safe and effective that hypertonic oxygen solution was infused during early postburn stage in severe burn patients. The patients＇ PaO2 and SaO2 could be increased and the ischemia and hypoxia in the tissue and cells could be improved by the infusion of hypertonic oxygen solution. Furthermore, the lipid hyperoxygen reaction could also be ameliorated and the free radical injury be corrected.

关 键 词：重症烧伤 高氧液 PAO2 SAO2 丙二醛 

分 类 号：R644[医药卫生—外科学]