高海拔地区危重烧伤ARDS/MODS的早期治疗

Early treatment of severely burned patients with ARDS/MODS at high altitude

目的:研究高海拔地区危重烧伤后呼吸窘迫综合征/多器官功能障碍综合征(ARDS/MODS)的早期治疗.方法:根据年龄、烧伤面积深度、吸入性损伤程度等影响因素,将过去13a35例危重烧伤患者分为2组:A组(n=15,1994-01/1999-12);B组(n=20,2000-01/2006-12).比较两组影响诊断治疗结局的主要危险因素和可能发生机制,探讨治疗中存在的问题.结果:A组呼吸机上机率41%;B组呼吸机上机率61%.A组发生器官衰竭人均(2.06±0.15)个;B组发生器官衰竭人均(2.15±0.34)个;累积病死率在9～12,13～16积分段上B组均低于A组.结论:根据高海拔地区ARDS/MODS评分标准诊断,积分在9～12,13～16分段的病例,有更多机会得到提早治疗,降低ARDS/MODS的病死率.

AIM： To study the early treatment of severely burned patients with ARDS/ MODS at high altitude. METHODS： According to the age, the burned area depth, inhalation hurt degree etc, 35 cases of severe burns were divided into 2 groups： group A（n = 15, 1994-01/1999-12）, group B（n =20, 2000-01/ 2006-12）. The risk factors influencing the final outcome of the patients and the possible mechanism were compared between the 2 groups to discuss the treatment protocols. RESULTS： The respirator wearing rate in group A was 41%, and 61% in group B. In group A, failure organs averaged 2. 06 ±0. 15 /person, and 2.15± 0. 34 /person in group B. Accumulative fatality in group B was lower than that in group A within integral sections of 9 - 12 and 1316. CONCLUSION： According to scoring criterion of ARDS/MODS at high altitude, the cases with scores within 9 - 12 and 13 - 16 sections have priority for early treatment so as to cut down the fatality of ARDS/MODS.