严重烧伤休克病人血乳酸监测与组织氧合相关性的临床研究  

Clinical Research for Relationship Between Blood Lactic Acid and Tissue Oxygenation in Severe Burn Patients with Shock

作　　者：苏青和[1] 虞俊杰[1] 杨敏杰[1] 周红梅[1] 朱菊琴[1] 

机构地区：[1]江苏省无锡市第三人民医院烧伤科,214041

出　　处：《中国微循环》2002年第5期287-288,F004,共3页Journal of Chinese Microcirculation

基　　金：江苏省科学技术厅资助课题 (批准号BS2000311)

摘　　要：目的探讨严重烧伤休克病人监测血乳酸 (BL)与组织氧合的相关性。方法早期收治的大面积烧伤病人34例 ,随机分为两组 ,改进组18例 ,采用改进后的休克复苏方案治疗 ,尿量维持于100ml/h左右 ;未改进组16例 ,常规复苏 (国内公式 ) ,尿量维持于40ml/h左右。两组同时于复苏前、复苏后1h、8h、16h、24h、48h、72h监测BL及传统监测指标 (尿量、心率 )。结果①烧伤休克乏氧代谢持续时间长 ,复苏时相应延长至72h ,且尿量应达100ml/h ,确保复苏达到终点。②复苏在传统监测指标 (心率、尿量 )指导下 ,治疗效果不佳 ,病死率高达31.2 % ;而改进组通过监测BL ,病死率仅为5.5 %。③有效的抗休克 ,组织器官缺血缺氧被纠正 ,随着BL值下降 ,患者的尿量逐渐增加 (两者呈负相关r= -0.91) ;同时心率逐渐减慢趋于正常 (两者呈正相关r=0.817)。结论严重烧伤休克时 ,组织器官灌注不足 ,组织的乏氧代谢增强 。Objective To investigate the relationship between blood lactic acid and tissue oxygenation in severe burn patients with shock.Methods 34 patients were randomly divided into two groups:improved group with 18 patients ,treated with improved shock treatment, urine excretion in 100ml±/h; Normal group with 16 patients, treated with national formula, urine excretion in 40ml±/h. Blood lactic acid and traditional parameters (urin, heart rate) were measured in 1h,8h,16h,24h,48h,72h before and after treatment in two groups.Results ①The treatment time for shock should be prolonged. ②The treatment for shock with traditional therapy was not good enough.The MODS rate was high and mortality was 31.2 %. But improved group was only 5.5 %. ③ There was a negative correlation between BL and urine volume(r=-0.91). Positive correlations were found between BL and heart rate(r=0.817).Conclusions There was a relationship between blood lactic acid and tissue oxygenation in severe burn patients with shock.

关 键 词：严重烧伤 休克病人 血乳酸监测 组织氧合 相关性 

分 类 号：R644[医药卫生—外科学]