早期输注高氧液对重症烧伤患者脂质过氧化反应的影响及注意事项  

Influence of early high oxygen fluid on lipid peroxidation reaction of severe burn patients

作　　者：吴红梅[1] 白翠翠[1] 李芳芹[1] 刘瑞宇[2] 

机构地区：[1]延安大学附属医院,陕西延安716000 [2]西安交通大学医学院第二附属医院骨一科,陕西西安710004

出　　处：《西部医学》2016年第12期1676-1679,共4页Medical Journal of West China

基　　金：国家自然科学基金(81101337);陕西省科技攻关项目(2002K10410)

摘　　要：目的探讨早期输注高氧液对重症烧伤患者脂质过氧化反应的影响。方法将2010年7月～2015年7月我院收治的80例严重烧伤患者按照随机数字表法分为实验组40例和对照组40例，两组患者均给予常规救治方案，对照组常规补液，1次／6h；实验组在常规治疗基础上以等量高氧液代替常规液体输注，1次／6h；两组患者均治疗3d。分别于高氧液输注前（T0）、输注24h（T1）、输注48h（T2）、输注72h（T3）检查患者血流动力学指标，评价两组急性生理与慢性健康评分（APACHEⅡ），采用血气分析仪检查两组患者动脉血氧饱和度（SpO2）和动脉氧分压（PaO2），酶联免疫吸附试验检测两组患者血清丙二醛（MDA）含量。结果两组患者治疗后中心静脉压（CVP）、心率（HR）有上升趋势，但T1、T2、T3与T0时点比较，差异无统计学意义（均P〉0．05），两组治疗前后各时段CVP、HR比较，差异亦无统计学意义（均P〉0．05）。两组患者治疗后APACHEⅡ评分、血清MDA水平均呈降低趋势，与T0时点比较，T1、T2、T3时点APACHEⅡ评分、血清MDA水平显著降低，其中实验组APACHEⅡ评分、血清MDA水平降低得更明显，两组治疗前后各时段APACHEⅡ评分、血清MDA比较，差异均有统计学意义（P〈0．05）。两组患者治疗后SpO2、PaO2均呈上升趋势，与T0时点比较，T1、T2、T3时点SpO2、PaO2显著升高，其中实验组SpO2、PaO2升高得更明显，两组治疗前后各时段Sp02、PaO2比较，差异均有统计学意义（P〈0.5）。结论早期输注高氧液能够改善重症烧伤患者的组织缺氧状态，避免早期氧自由基所产生的脂质过氧化反应，对预防多器官功能衰竭具有积极作用。Objective To explore the influence of early high oxygen fluid on lipid peroxidation reaction of severe burn patients. Methods 80 severe burn patients treated in hospital from July 2010 to July 2015 were divided into experimental group （40 cases） and control group （40 cases）. The patients of the two groups were treated with conventional treatment. The control group was given fluid infusion, 1 times/6h. The experimental group was treated with high oxygen liquid, 1 times/6h. Hemodynamics were examined in two groups before（T0） and after 24h（T1 ）,48h（T2 ）,72h（Ta） infusion high oxygen fluid. The acute physiology and chronic health score （APACHE II ）, arterial blood oxygen saturation （SpO2） and arterial oxygen partial pressure （PaO2） were examined by blood gas analyzer. The content of serum malondialdehyde was detected by enzyme-linked immunosorbent assay. Results After treatment, CVP and HR of the two groups showed an upward trend,but CVP and HR at T1, T2, T3 and TO had not statistical difference （P〉0.05）. After treatment, APACHE II score and serum MDA levels of the two groups showed a decreased trend. APACHE II score and serum MDA at To were different from that at T1, T2, Ta. Compared with that of control group, APACHE II score and serum MDA of experimental group obviously decreased. APACHE II score and serum MDA at each time point before and after treatment of the two groups were statistically different （P〈0.05）. After treatment, SpO2 and PaO2 showed a increased trend. Compared with that at T0, SpO2 and PaO2 at T1 , T2 and T3 were significantly reduced. SpO2 and PaO2 of experimental group more obviously decreased than that of control group. SpO2 ,PaO2 at each time point before and after treatment were statistically different （P〈0.05）. Conclusion Early infusion with high oxygen fluid can improve tissue hypoxia in patients with severe burn, avoid lipid peroxidation produced by oxygen free radicals and play positive role in the prevention with multiple organ failure.

关 键 词：高氧液 重症烧伤 脂质过氧化反应 动脉血气 注意事项 

分 类 号：R644[医药卫生—外科学]