不同方法评估重度烧伤清创植皮术患儿术中出血量准确性的比较

Accuracy of different methods for estimating blood loss during burn wound excixion and skin grafting in pediatric patients with severe burn

目的 比较手术面积和手术面积与血容量乘积（手术面积×血容量）评估重度烧伤清创植皮术患儿出血量的准确性.方法 拟行切削痂、清创植皮手术的重度烧伤患儿20例,年龄7 d～8岁,性别不限,体重4～22 kg,烧伤后5～10 d,烧伤面积15%～50%,手术面积10%～46%.计算术中总出血量,手术面积和手术面积×血容量与总出血量行直线相关和直线回归分析.结果 手术面积和手术面积×血容量与总出血量的相关系数分别为0.776和0.889,比较差异有统计学意义（P＜0.05）;总出血量（Y）与手术面积（X1）、手术面积×血容量（X2）直线回归方程分别为：Y=25.094X1-122.431和Y=0.020X2＋16.142.结论 与手术面积比较,手术面积×血容量能更准确地评估重度烧伤清创植皮术患儿的术中出血量.

Objective To evaluate the accuracy of different methods for estimating blood loss during burn wound excixion and skin grafting in pediatric patients with severe burn. Methods Twenty pediatric patients of both sexes aged 7 days-8 yr weighing 4-22 kg undergoing burn wound excision and skin grafting were enrolled in this clinical study. Two methods were used for estimating blood loss during operation： Method Ⅰ： surgical surface area （SSA）. MethodⅡ： the product of SSA and blood volume （BV）. Total blood loss was calculated： total blood loss = BV （ Hct0 - Hctx ） ÷ Hct0 ＋ Tx. Hct0 =Hct before operation. Hctx =Hct at the end of operation. Tx =total amount of blood transfusion. Results The correlation between the total blood loss and SSA was 0.776. The correlation between the total blood loss and the product of SSA and BV was 0.889. The difference was statistically significant. Conclusion The product of SSA and BV is more accurate in estimating blood loss during burn wound excision and skin grafting in children with severe burn.