成批大面积烧伤患者的组织救治效果分析

Effect analysis of organization of treatment of large area burns in batches

目的 分析成批大面积烧伤患者的组织救治效果。方法 19批(79例)烧伤面积>30%的大面积烧伤患者,均接受补液等药物治疗、气管切开、创面治疗以及其他治疗。记录治疗结果,并比较治疗前后患者的生长因子[血管内皮生长因子(VEGF)、S100钙结合蛋白A9(S100A9)、碱性成纤维细胞生长因子(bFGF)]水平、疼痛因子[P物质(SP)、前列腺素E2(PGE2)、环氧化酶2(COX-2)]水平。结果 79例患者治愈69例,死亡10例,其中4例死于创面感染,2例死于重度吸入性损伤,1例死于后期气管切开的无名动脉出血,1例死于肾衰竭,1例死于继发性肺炎,1例死于导管败血症。治疗后,患者的VEGF(265.73±18.49)μg/L、S100A9(176.49±10.18)μg/L、bFGF(274.85±18.63)μg/L均高于治疗前的(110.54±7.63)、(80.53±3.12)、(101.52±7.24)μg/L,差异有统计学意义(P<0.05)。治疗后,患者的SP、PGE2、COX-2分别为(46.53±5.11)ng/ml、(124.39±10.67)pg/ml、(53.47±3.42)ng/ml,均低于治疗前的(75.29±10.24)ng/ml、(238.74±20.15)pg/ml、(126.79±10.82)ng/ml,差异有统计学意义(t=22.337、44.576、57.429,P=0.000、0.000、0.000<0.05)。结论 针对成批大面积烧伤患者实施组织救治的效果显著,有利于减轻疼痛程度,调节生长因子水平,临床可进一步推广应用。

Objective To analyze the treatment effect of large area burns in batches.Methods 19 batches(79 cases) of large-area burn patients with burn area > 30% were enrolled in this study,who received fluid infusion,tracheotomy,wound treatment and other treatments.The treatment results were recorded,and the levels of growth factor [vascular endothelial growth factor(VEGF),S100 calcium binding protein A9(S100A9),basic fibroblast growth factor(bFGF)],pain factor [substance P(SP),prostaglandin E2(PGE2),and cyclooxygenase-2(COX-2)] before and after treatment were compared.Results 69 of 79 patients were cured and 10 cases died,of which 4 cases died from wound infection and 2 cases died from severe inhalation injury;1 case died from bleeding from the anonymous artery caused by tracheostomy in the later stage,1 case died from renal failure,1 case died from secondary pneumonia,and 1 case died from catheter-related sepsis.After treatment,VEGF was(265.73±18.49) μg/L,S100A9 was(176.49±10.18) μg/L,bFGF was(274.85±18.63) μg/L,which were higher than those of(110.54±7.63),(80.53±3.12) and(101.52±7.24) μg/L before treatment,and the difference was statistically significant(P<0.05).After treatment,the levels of SP,PGE2 and COX-2 of patients were(46.53±5.11) ng/ml,(124.39±10.67) pg/ml and(53.47±3.42) ng/ml,which were lower than those of(75.29±10.24) ng/ml,(238.74±20.15) pg/ml and(126.79±10.82) ng/ml before treatment,and the difference was statistically significant(t=22.337,44.576,57.429;P=0.000,0.000,0.000 < 0.05).Conclusion For large area burn patients in batches,the organization of treatment has a significant effect,which is conducive to reducing the degree of pain and regulating the level of growth factors,and can be further promoted in clinical application.