特重度烧伤并发高钠血症连续性血液净化治疗  

Continuous hemopurification therapy in extremely severe burn with hypernatremia

作　　者：杨福旺[1] 童亚林[1] 朱金红[1] 龚震宇[1] 辛海明[1] 朱富军[1] 蒋晓臣[1] 邓建军[1] 缪洪城[1] 

机构地区：[1]中国人民解放军第181医院烧伤整形中心(外科重症监护病区),广西桂林541002

出　　处：《临床急诊杂志》2015年第9期690-692,697,共4页Journal of Clinical Emergency

基　　金：全军医学科学技术研究"十二五"计划(No:CWS11J277);广西自然科学基金(No:桂科自0728255;0991290);广西科学研究与技术开发计划(No:桂科攻1140003A-39)

摘　　要：目的:探讨连续性血液净化在特重度烧伤并发高钠血症治疗中的应用价值。方法:选择我院烧伤科60例特重度烧伤并发高钠血症患者,将其随机分为血液净化组(30例)及常规治疗组(30例),血液净化组在常规治疗的基础上进行连续性血液净化治疗2d。分别于治疗前(确诊高钠血症时)及治疗后1、2d,观察血清钠浓度、渗透压、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)、血流动力学、血气分析等的变化。结果:血液净化组患者治疗后生命体征明显改善,血清钠浓度、渗透压、APACHEⅡ评分、血流动力学、氧分压变化的数据较常规治疗组治疗后有明显改善,差异有统计学意义(P<0.05)。结论:连续性血液净化治疗特重度烧伤并发重度高钠血症效果确切,安全性好,能改善其预后,值得临床推广。Objective：To study the application value of continuous hemopurification therapy in extremely severe burn associated with hypernatremia.Method：Sixty patients with extremely severe burn associated with hypernatremia were randomly divided into conventional treatment group（CT,n=30）and continuous renal replacement therapy group（Hemopurification,n=30）.Patients in group continuous hemopurification received both conventional treatment and continuous hemopurification therapy for 2days.The relationship between hypernatremia and disease condition were observed before treatment,one day and two days after treatment.The changes of serum sodium concentration,osmotic pressure,acute physiology and chronic health evaluationⅡ（APACHEⅡ）,hemodynamic and blood gas were detected before and after continuous hemopurification.Result：Vital signs of patients in continuous hemopurification group improved significantly compared with that in CT group including serum sodium concentration,osmotic pressure,APACHEⅡ,hemodynamic and oxygen partial pressure（P〈0.05）.Conclusion：Continuous hemopurification treatment in extremely severe burn associated with hypernatremia can improve the patients＇ prognosis and is worthy of clinical promotion.

关 键 词：连续性血液净化 高钠血症 特重度烧伤 

分 类 号：R644[医药卫生—外科学]