大面积烧伤并发应激性溃疡出血防治

Prevention and treatment of stress ulcer bleeding in patients with extensive burns

目的探讨大面积烧伤并发应激性溃疡出血的预治措施。方法回顾性总结作者在两所医院12年间治疗大面积烧伤(n=1093)并发应激性溃疡的发生率。结果治疗组(n=1093)大面积烧伤病例并发应激性溃疡35例(发生率为3.2%),对照组(文献报道n=1023),并发应激性溃疡出血70例(发生率6.8%),两组统计学分析有显著差异性(P<0.01)。结论严重烧伤病人采取积极液体复苏,尽早进食,积极防治感染和创面处理,常规应用抗酸剂,止痛,吸氧等综合性预防措施,可明显降低应激性溃疡出血发生率。

Objective To review the measures for prevention and management of stress ulcer bleeding in patients with extensive burns. Methods A retrospective study was conducted in 1093 extensively burned patients to understand the incidence of stress ulcer bleeding in comparison with the results according to the literature reports. Results The incidence of stress ulcer bleeding was 3.2% in these patients, significantly lower that reported in literatures （6.8%, n=1023） （P〈0.01）. Conclusion Comprehensive measures should be taken in extensively burned patients, such as shock resuscitation, early feeding, adequate infection and wound management, use of antacid, painkiller and oxygen therapy, which may help reduce the risks of stress ulcer bleeding.