大面积严重烧伤病人回吸收期血管外肺水指数变化与肺功能关系研究  

Changes of extravascular lung water index in patients with a large area of severely burn during back to absorption and relationship between it and lung function

作　　者：余水秀[1] 王仙园[1] 周娟[1] 吴军[2] 彭毅志[2] 彭代智[2] 罗高兴[2] 罗奇志[2] 颜洪[2] 李晓鲁[2] 张家平[2] 

机构地区：[1]中国人民解放军第三军医大学护理学院 [2]中国人民解放军第三军医大学西南医院

出　　处：《护理研究（上旬版）》2013年第6期1555-1557,共3页Chinese Nursing Researsh

基　　金：国家自然科学基金面上项目;编号:81171810;军队"十二五"重点项目;编号:BWS11J039

摘　　要：[目的]观察大面积严重烧伤病人回吸收期血管外肺水指数(EVL-WI)的变化规律,探讨其与病人肺功能变化的关系。[方法]观察对象为我院收治入院的大面积严重烧伤的16例病人,于伤后第2个24h后期进行心肺容量监护仪(PiCCO)监测至伤后9d结束,监测指标包括EVLWI、肺血管通透性指数(PVPI)和氧合指数,同时观察病人肝、肾、心功能情况。[结果]休克期末(伤后2d)病人EV-LWI为6.71 mL/kg±1.07 mL/kg,均值处于正常上限,进入回吸收期后进一步升高,于伤后第5天达最高值7.75mL/kg±1.82mL/kg,至伤后第9天仍高于休克期末水平(EVLWI为6.92mL/kg±1.47mL/kg)。休克期末病人氧合指数为411.49mmHg±106.04 mmHg(1 mmHg=0.133kPa),均值处于正常下限,随后进行性下降,于伤后第5天达到最低值,为343.35mmHg±85.77mmHg,至伤后第9天仍低于休克期末水平为(368.51mmHg±64.13 mmHg);相关分析显示,病人EVLWI与氧合指数呈负相关(r=-0.16,P<0.05)。休克期末病人PVPI为1.60±0.28,随后下降,至伤后第7天达最低值1.29±0.25,与休克期末比较差异有统计学意义(P=0.006)。[结论]大面积严重烧伤病人血管外肺水在回吸收期进一步增高,可能是导致病人肺功能进行性下降的重要原因。Objective： To observe the changes of extravascular lung water index（EVLWI） in patients with a large area of severely burned during back to absorption,and probe into the relationship between EVLWI and pulmonary function changes. Methods：A total of 16 patients with a large area of severely burn were collected. All the patients received PiCCO cardiopulmonary capacity monitoring from later period of second 24 hours after burn to the ninth day after burn. The monitoring indexes included EVLWI,pulmonary vascular permeability index（PVPI） and PO2/FiO2. We will record the cardiac function, kidney function and liver function of patients. Results.The EVLWI value of patients at the end of shock period （2 d after burn） was 6.71 mL/kg± 1.07 mL/kg, and the average value was at normal upper limit. The record of EVLWI further increased during back to absorption, and it had a highest value on the fifth day after burn. The value was（7.75± 1.82）mL/kg. On the ninth day after burn,the value of EVLWI was higher than that at the end of the second 24 hour after burn [EVLWI value was （6.92±1.47） mL/kg]. The PO2/FiO2 was （411.49±106.04） mmHg at the end of the second 24 hour after burn,and the mean value was at normal upper limit,and then followed by a progressive decline. It had a lowest value on the fifth day after burn. The value was （343.35±85.77） mmHg. On the ninth day after burn, the value of PO2/FiO2 was still lower than that at the end of the second 24 hour after burn（PO2/FiO2 value was 368. 51 mmHg±64. 13 mmHg）. Correlation analysis showed that the EVLWI of patients was negatively correlated with the PO2/FiO2 （r=-0. 16,P〈0. 05）. The PVPI was within the normal range at the end of the second 24 hour after burn,and the value was （1.60±0.28）. Then it descended,and it had a lowest value on the seventh day after burn. The value was 1.29±0.25 ,and there was a significant difference compared with that at the end of the shock period （P=0.006）. Conclusion：The EVLWI of patients with

关 键 词：重度烧伤 肺氧合指数 血管外肺水指数 肺血管通透性 

分 类 号：R473.6[医药卫生—护理学]