重度烧伤患者回吸收期血管外肺水变化规律及与肺功能的相关性分析  

Changes of extravascular lung water and correlation with lung function in severely burned patients during resorption

作　　者：罗春娟[1] 徐白 LUO Chunjuan;XU Bai(Department of Orthopedic Surgery,Chinese People＇s Liberation Army of 118 Hospital,Wenzhou 325000,China)

机构地区：[1]中国人民解放军第118医院烧伤整形外科,浙江温州325000

出　　处：《全科医学临床与教育》2018年第6期644-646,共3页Clinical Education of General Practice

摘　　要：目的分析重度烧伤患者回吸收期血管外肺水变化规律及与肺功能的相关性。方法收集31例重度烧伤患者,入院后给予常规治疗并采用PiCCO监测评估患者的血管外肺水指数(EVLWI)和肺血管通透性指数(PVPI),计算氧合指数(PaO2/FiO2),并采用相关性分析分析EVLWI、PVPI与PaO2/FiO2的关系。结果重度烧伤患者EVLWI从休克末期开始升高,创伤第7天短暂下降后再次升高,创伤第10天EVLWI仍明显高于休克末期(t=5.29,P<0.05);而PVPI从休克末期开始呈下降趋势,于第8天短暂升高后继续下降,第10天PVPI明显低于休克末期(t=6.14,P<0.05)。重度烧伤患者休克末期PaO2/FiO2在(416.25±56.30)mmHg,处于正常值范围。而进入回收期后的伤后第3天,患者的PaO2/FiO2开始逐渐下降,至创伤第10天明显低于休克末期水平(t=9.61,P<0.05)。相关性分析显示EVIWI与PaO2/FiO2呈负相关关系(r=-0.31,P<0.05),而PVPI与PaO2/FiO2呈正相关关系(r=0.26,P<0.05)。结论重度烧伤患者回收期血管外肺水指数总体上呈现升高的趋势,与患者的肺功能存在明显相关性。Objective To analyze the changes of extravascular pulmonary water and its correlation with pulmonary function in patients with severely burned during resorption. Methods Thirty-one patients with severe burns were given routine treatment after admission. Extravascular lung water index（EVLWI）and pulmonary vascular permeability index （PVPI）were assessed by PiCCO monitoring. Oxygenation index（PaO2/FiO2）was calculated and the relationship between EVLWI,PVPI,and PaO2/FiO2 was analyzed. Results EVLWI of severely burned patients was gradually elevated from the end of shock to the 6th day after trauma,and then increased again after a short decrease on the 7th day after trauma.EVLWI was still significantly higher on the 10th day after trauma than that at the end of shock（t=5.29,P〈0.05）. PVPI gradually decreased from the end of shock to the 7th day after trauma,and then continued to decrease after a short increase on the 8th day after trauma. PVPI was significantly lower on the 10th day than that at the end of shock（t=6.14,P〈0.05）. The PaO2/FiO2 at the end of shock of severely burned patients is（416.25 ±56.30）mmHg,which is in the normal range. On the third day during resorption,PaO2/FiO2 began to decrease gradually,and on the 10th day,it was significantly lower than that at the end of shock（t=9.61,P〈0.05）. Correlation analysis showed that EVIWI was negatively correlated with PaO2/FiO2（r=-0.31,P〈0.05）,while PVPI was positively correlated with PaO2/FiO2（r= 0.26,P〈0.05）. Conclusion EPWI during resorption in severely burned patients shows increasing trends in general,and it has a significant correlation with pulmonary function.

关 键 词：重度烧伤 回收期 血管外肺水 肺功能 氧合指数 

分 类 号：R644[医药卫生—外科学]