严重烧伤患者早期短程应用高效抗生素的研究

Clinical study on the early and short-term use of antibiotics with broad spectrum in severely burned patients

目的 探讨早期短程应用高效抗生素对严重烧伤后患者感染的防治效果。 方法 烧伤患者 35例 ,烧伤面积 5 0 %～ 95 %。根据高效抗生素使用时机分为早防组 (2 0例 ,伤后 6h内开始 )和迟防组 (15例 ,伤后 48h开始 )。动态检测血浆内毒素 (lipopolysaccharide,LPS)、肿瘤坏死因子(TNFα)和白细胞介素 8(IL 8)的变化 ,严密观察脓毒症各项指标。 结果 大面积烧伤后血LPS、TNFα和IL 8明显升高 ,于伤后 3～ 5d达高峰 ,但早防组明显低于迟防组 (P <0 0 5～ 0 0 0 1)。伤后2周内脓毒症、内脏并发症的发生率 ,早防组明显低于迟防组 (P <0 0 5 ) ;伤后 4～ 7d痂下组织菌量 ,早防组明显低于迟防组 (P <0 0 1)。 结论 严重烧伤早期短程使用高效抗生素 ,能有效预防烧伤后感染 。

Objective To investigate the prevention and treatment effects of early and short-term use of antibiotics with broad spectrum on postburn severe infection in severely burned patients . Methods Thirty-five burn patients with TBSA from 50% to 95% were enrolled in the study.The patients were divided into early prevention[20 cases,antibiotics were used started from 6 postburn hours(PBH)] and delayed prevention(15 cases,antibiotics were applied after 48 PBH) groups.Plasma levels of LPS,TNFa and IL-8 were d...