严重烧伤后渗透分子清除率和自由水清除率变化及其临床意义

CHANGES OF CLEARANCES OF Osmole AND FREE WATER IN BURN PATIENTS AND THEIR CLINICAL SIGNIFICANCE

本文测定了59例不同烧伤面积病人血、尿晶体渗透压,计算渗透分子清除率(Cosm)和自由水清除率(C_(H_2O))并进行了动态观察。结果发现随着烧伤面积增加,血晶渗压(Posm)和C_(H_2O)升高,而尿晶渗压(Uosm)和Cosm下降,尤以TBSA>80％组变化最为显著,ARF组较non—ARF变化明显。死亡病人生前Posm、C_(H_2O)明显高于而Uosm、Cosm明显低于存活病人,且Posm、C_(H_2O)增加与Uosm、C_(H_2O)降低往往同时存在。测定Posm、Uosm、Cosm、C_(H_2O)对严重烧伤后肾功能损害监测。

The plasma and urine osmolality and clearances of osmole (Cosm) and free water (Cn,o) in 59 burn patients were determined with freezing point depressing method. The results showed that there were significant increases of Posm and CH2O and decreases of Uosm and Cosm in the burn patients, which correlated positively to the extents of the burn injury as well as the severity of renal damage. The Cosm significantly decreased and CH2O increased before the death. The findings suggested that the determination of Posm, Uosm, Cosm and CH2O might be helpful to understanding postburn renal damage and severity of the burn injury and evaluating the prognosis of the injury.