严重烧伤延迟复苏患者应激性溃疡出血的早期综合防治

Early comprehensive prevention and treatment of stress ulceration hemorrhage in patients with delayed fluid resuscitation

目的 总结提高严重烧伤延迟复苏患者应激性溃疡的早期综合防治经验。方法 将 72例严重烧伤延迟复苏的患者按不同时期治疗措施的不同分成两组 ,即 1990 -0 1～ 1994-12 (第一阶段 ,n =2 6)及 1995-0 1～ 2 0 0 1-12 (第二阶段 ,n =46) ,进行比较分析。结果 第二阶段烧伤治愈率升高 ,死亡率下降 ,应激性溃疡出血的发生率明显下降 (P <0 .0 1～ 0 .0 5)。结论 综合液体复苏方案 ,细胞保护 ,保护胃肠道黏膜的功能 ,早期切 (削 )痂 ,早期肠道喂养 。

Objective To summarize the therapy of stress ulceration hemorrhage in patients with delayed fluid resuscitation. Methods From January 1990 through December 2001, 72 cases with delayed fluid resuscitation were admitted to our burn department and were divided into two groups namely 1990 to 1994(group I,n=26) ,and 1995 to 2001 (group II,n=46). Results Incidence of stress ulceration hemorrhage was very significantly lower than that of group I. Conclusion The survival rate increased significantly due to improvement of early, rapid and compound resuscitation regime, early escharectomy, protection of gastric mucosa function, early enteral feeding , early tracharectomy, and avoiding systemic infection.