严重烧伤延迟复苏的综合液体复苏策略的研究  

STUDY ON THE COMPREHENSIVE RESUSCITATION STRATEGY ON SEVERE BURNED PATIENTS WITH DELAYED FLUID RESUSCITATION

作　　者：吴祖煌[1] 卓燕舞[2] 宋斌[1] 姜新华 陈国养[1] 

机构地区：[1]福建省解放军福州总医院第一附属医院(福建医科大学福总临床医学院)烧伤整形科,莆田351100 [2]福建省莆田学院附属医院小儿科 [3]福建省解放军马尾海军医院

出　　处：《现代预防医学》2011年第8期1562-1563,1566,共3页Modern Preventive Medicine

基　　金：莆田市科技计划项目[2004S02(2)]

摘　　要：[目的]探讨严重烧伤延迟复苏患者的液体复苏方法,提高烧伤休克复苏质量。[方法]将72例严重烧伤延迟复苏的患者按不同时期治疗措施的不同分成2组,即2000年1月～2004年12月(常规组)及2005年1月～2008年12月(综合组),进行比较分析。[结果]综合组休克纠正时间缩短,尿液转碱时间提前,伤后第1个24 h、第2个24 h的输液总量及尿量均明显增加。综合组BLA、BD、CK-MB、GPT、Cr、BUN等指标下降(P﹤0.01～0.05)。[结论]快速有效的综合复苏、细胞保护、抗氧化治疗、蛋白酶抑制剂、钙通道阻滞剂、抗炎治疗、早期肠道营养和保护性肺通气策略等构成的综合复苏策略能更加有效地提高严重烧伤延迟复苏的休克复苏质量。[Objective]To summarize the therapeutic of comprehensive resuscitation strategy on severe burned patients with delayed fluid resuscitation.[Methods]From January 2000 through December 2008,altogether 72 cases delayed fluid resuscitation were admitted to our burn department.Two groups were divided and analyzed retrospectively,namely 2000 to 2004（group I）,and 2005 to 2008（group II）.Creatine kinase isoenzymes（CK-MB）,creatinine（Cr）,blood urea nitrogen（BUN）,glutamic-pyruvic transaminase（GPT）,base deficit（BD）and blood latic acid（BLA）were determined.[Results]（1）The serum levels of CK-MB,GPT,BUN and Cr in group II were evidently lower than those of group I（P﹤0.01-0.05）.（2）The serum BD and BLA were increased at all times in two periods and was markedly increased in group I（P﹤0.01）.[Conclusion]The strategy including early rapid and compound resuscitation,cytoprotection,antioxidant,metalloproteinases,calcium channel blockers,antiinflammatory therapy,early enteral feeding and protective ventilation.The strategy can improve the effect of resuscitation on severe burned patients with delayed fluid resuscitation.

关 键 词：烧伤 延迟复苏 综合复苏 细胞保护 

分 类 号：R644[医药卫生—外科学]