摘要
目的探讨严重烧伤病人休克期烧伤面积及体质量与补液质、量和补液速度的关系,为临床治疗提供借鉴。方法收集青岛市市立医院2002年10月—2009年1月收治的烧伤面积〉50%、年龄〉14岁、伤后到入院时间〈6 h并且平稳渡过休克期的烧伤病人。统计其烧伤后第1个24 h前8 h、后16 h与第2个24 h补充晶体、胶体、水份的量及晶体-胶体比值,并与全国通用补液公式比较。结果第1个24 h晶体-胶体实际补液总量、第2个24 h晶体-胶体实际补液总量与全国通用补液公式标准比较,差异有显著性（t=2.557、4.647,P均〈0.05）。第1个、第2个24 h补液晶体-胶体比值〉1,与全国通用补液公式标准比较,差异有显著性（t=6.67-11.10,P均〈0.05）。第1个24 h、第2个24 h补充的水份〉2 000 mL,与全国通用补液公式标准比较,差异有显著性（t=5.30、10.93,P均〈0.05）。前8 h补充的晶体-胶体补液总量小于后16 h,差异有显著性（t=-5.32,P〈0.05）。结论现行的全国通用补液公式晶体、胶体和水份的估计量偏低,晶体-胶体比尚适中,补液速度高于临床补液速度,建议在临床应用中进行必要的调整。
Objective To investigate the relationship between the extent of burn,body weight and fluid replacement in patients with severe burn at shock stage for reference of clinical therapy. Methods Clinical data of burn patients with extent of burn 50%,age 14 years,hospitalized in Qingdao Municipal Hospital,during Oct.2002—Jan.2009,within 6 hours after burn and stably passed through shock stage,were collected.The amount of crystal,colloid,water,and the ratio of crystal and colloid in the first 8 hours,the next 16 and the second 24 hours were compared with the National Formula of Resuscitation（NFR）.Results Compared with the NFR standard,the difference was significantly shown as follows： the actual amount of fluid replacement,both crystal and colloid,in the first and second 24 hours（t=2.557,4.647;P〈0.05）;Water supplement in the first and second 24 hours,the ratio of crystal/colloid was 1（t=6.67,11.10;P〈0.05）;The water content supply in the first and second 24 hours was〉 2 000 mL,respectively（t=5.30,10.93;P〈0.05）;The amount of crystal and colloid supplement in the first 8 hours was smaller than that of the second 16 hours（t=-5.32,P〈0.05）. Conclusion In the currently-used NFR,the estimated amount of crystal,colloid and water is a little lower;the ratio of crystal and colloid is proper;the rate of fluid replacement is faster than that in clinical practice.Clinically,a necessary adjustment is suggested.
出处
《齐鲁医学杂志》
2011年第1期55-56,58,共3页
Medical Journal of Qilu
