烧伤休克期补液公式的改进与临床应用  

IMPROVEMENT AND APPLICATION OF THE FLUID REPLACEMENT FORMULA IN BURN SHOCK

作　　者：王车江[1] 张庆富[1] 刘洪霞[2] 冯建科[1] 白永强[1] 邵洪波[1] 

机构地区：[1]河北医科大学第一医院烧伤整形科,河北石家庄050031 [2]河北医科大学第一医院肝病中心,河北石家庄050031

出　　处：《河北医科大学学报》2010年第2期157-160,共4页Journal of Hebei Medical University

摘　　要：目的比较2个烧伤补液公式对烧伤休克复苏的近期影响,探讨补液公式的改进。方法特重度烧伤患者89例分为2组,参考教科书中"国内常用公式,补液量(mL)=体表面积(total bodysurface ariea,TBSA)%×体质量(kg)×1.5+水分2 000 mL"进行补液的为对照组(38例),依据"改进公式,补液量(mL)=TBSA(%)×体质量(kg)×2(?)水分3 000 mL"补液的为试验组(51例)。比较2组复苏即刻和48 h的心率、尿量、电解质、血浆渗透压及血液浓缩情况。结果①伤后8 h内,试验组心率较慢为(101.33±15.28)次/min,与对照组(122.08±20.83)次/min比较差异有统计学意义(P<0.05)。试验组尿量较多为(2.11±0.78)mL·h^(-1)·kg^(-1),与对照组(1.53±0.41)mL·h^(-1)·kg^(-1)比较差异有统计学意义(P<0.05)。②伤后48 h,对照组血浆渗透压为(317.15±11.05)mmol/L,试验组为(303.87±9.52)mmol/L,2组比较差异有统计学意义(P<0.05)。对照组钠(Na^+)离子(149.12±9.64)mmol/L,与试验组(141.52±5.84)mmol/L比较差异有统计学意义(P<0.05)。2组红细胞压积比较,差异有统计学意义(P<0.05)。结论成人特重度烧伤休克复苏时,依据"改进公式"补液,心率减慢,尿量增加.血液浓缩情况得到改善。Objective To explore a suitable fluid replacement formula in burn patients with shock. Methods Eighty-nine patients with total body surface area（TBSA） burned over 50%,or 20% in third-degree burns were enrolled in this study. The patients were divided into two groups （experimental group 51 cases, control group 38 cases）, The patients in control group were treated with universal formula of fluid replacement, the experimental group with the modified formula. heart rate（HR）, urine volume（UV）, K^＋ , Na^＋ concentration（ [Na^＋ ]i） （[K^＋ ]i）, plasma osmolality （PO）, hematocrit （HCT）, hemoglobin （HGB） concentration of both groups were compared. Results （1） HR of experimental group [（101.33±15.28） times per miniter,tpm] was lower than that of control group（ P 〈0.05） ,and UV of experimental group [（2.11±0.78）mL · h^-1 · kg^-1] was more than that of control group （P 〈 0.05）. （2） At 48 hour after injury, there were statistically significant difference between experimental group and control group in PO [（303.87±9. 52） mmol/L vs （317.15±11.05）mmol/L, P 〈0.05],[Na^＋]i and HCT（P 〈0.05）. Conclusion According to the modified fluid replacement formula in the stage of burn shock resuscitation, the heart rate decreased, urine volume increased, and blood concentration was improved.

关 键 词：烧伤 休克 补液疗法 

分 类 号：R644[医药卫生—外科学]