延迟复苏对特重烧伤患者预后的影响

Effect of Delayed Fluid Resuscitation on the Therapeutic Prognosis of Severely Burned Patients

【目的】探讨延迟复苏对特重烧伤患者预后的影响,认识早期及时有效的复苏对特重烧伤患者预后的重要意义。【方法】回顾性分析198例特重烧伤患者的治疗情况,并根据烧伤后开始复苏时间的早晚将患者分为A(0～6h)、B(6h以上)两组,比较两组患者在早期休克发生率、休克期平均复苏补液量、后期严重并发症发生率、病死率及治愈平均疗程等方面有何不同。【结果】A、B两组患者在平均年龄、平均烧伤面积、平均Ⅲ度面积等方面无明显差异的情况下,通过比较发现A、B两组患者在早期休克发生率、休克期平均复苏补液量、后期严重并发症发生率、病死率及治愈平均疗程等方面均具有显著差异(P<0.01)。【结论】延迟复苏可以使特重烧伤患者早期休克发生率增高、休克期复苏补液量增加、后期严重并发症发生率、死亡率增高,疗程延长。

[Objective]To study the effect of delayed fluid resuscitation on the therapeutic prognosis of severely burned patients.[Methods]One hundred ninety-eight patients with severe burns were divided into A(0~6 hours) and B(more than 6 hours) groups according to the beginning time of fluid resuscitation. The shock incidence in early stage, the mean millilitres of fluid resuscitation in shock stage, the incidence of severe complications in late stage, the mortality and the mean hospitalization days were calculated in both groups. [Results] Although there was no obvious difference about the mean age,the mean TBSA and the mean area of third-degree burn between group A and group B, but the results demonstrated significant increases about the shock incidence in early stage, the mean millilitres of fluid need in shock stage, the incidence of severe complications in late stage, the mortality and the mean hospitalization days of group B compared with those of group A(P<0.01).[Conclusion]Delayed fluid resuscitation always leads to the increase of the shock incidence in early stage, the mean millilitres of fluid need in shock stage,the incidence of severe complications in late stage, the mortality and the mean hospitalization days. Consequently, timely effective fluid resuscitation in early stage plays an important role in the therapy of severely burned patients.