计算机模拟设计湿性医疗技术休克期液体复苏方案研究

Study on Computer-simulated Design of Fluid Resuscitation Protocol of Moist Regenerative Therapy at Shock Stage

目的提供理想的休克期液体复苏方案,使烧伤患者减轻水肿,平稳度过休克期。方法根据经湿性医疗技术治疗的烧伤患者休克期液体和蛋白质平衡的数学模型,利用系统控制的计算机模拟技术,对实验组的31例烧伤患者进行液体复苏治疗,并与采用传统经验补液公式复苏的对照组29例患者复苏情况进行比较、分析。结果采用新方案进行治疗的患者,补液总量比传统方案治疗者减少约15%～20%,患者尿量满意,水肿(净体重增加)较轻,更易平稳度过休克期,且平均住院时间、医疗费用及感染并发症也较少(P<0.05)。结论计算机模拟设计的湿性医疗技术休克期液体复苏方案能更好地满足采用湿性医疗技术治疗的患者休克期复苏需要,比传统经验公式更科学、合理,既能使烧伤患者平稳度过休克期,又可减轻水肿,减少并发症。

Objective To provide an ideal fluid resuscitation protocol at the shock stage so as to relieve burn patients＇ edema and make sure the safe transition of shock stage. Methods According to the mathematical model of the body fluid and protein balance of burn patients at shock stage treated with Moist Regenerative Therapy, making use of the system-controlled computer simulation technique, an experiment group with 31 burn patients were treated with fluid resusci-tation and the treatment results were compared with that of 29 patients treated according to the traditional fluid resuscitation formula （ control group）. Results The fluid replacement volume of burn patients treated with the new protocol was approxi- mately 15% -20% less than the traditional protocol. The urine output was satisfying and the edema （net gain of weight） was mild. In the experiment group, the patients tended to live through the shock stage more smoothly with a shorter average hospitalization time, less medical cost and infection occurrence （P 〈 0.05）. Conclusion The shock-stage fluid resuscita- tion protocol of moist regenerative therapy designed by computer simulation can better meet the resuscitation need of burn pa- tients at shock stage and is more scientific and rational than the traditional empirical formula in that it can not only help the patients live through the shock stage smoothly and also relieve the edema and reduce complications.