计算机模拟分析不同治疗方法对烧伤休克期体液变化及复苏的影响

Influence Analysis of Different Treatment Therapies on Body Fluid Changes and Resuscitation of Burns at the Shock Stage by Computer Simulation

目的比较不同的创面治疗方法对烧伤休克期体液变化及液体复苏的影响。方法随机选择烧伤面积为30%TBSA^90%TBSA的严重烧伤患者,分别采用烧伤再生医疗技术(A组,30例)和传统的磺胺嘧啶银霜抗炎疗法(B组,30例)治疗,通过计算机模拟分析两组患者休克期体液变化及液体复苏情况,比较治疗效果。结果 A组患者休克期补液量、净体重增加量(水肿)、平均住院时间、医疗赞用情况和全身感染性脓毒血症发生率均明显低于B组,差异有统计学意义(P<0.05)。虽然A组患者尿量多于B组、休克征象发生率低于B组,但P>0.05,差异无统计学意义。结论 在重度烧伤治疗中,不同的创面治疗方法对烧伤休克期患者体液变化、复苏及预后均有影响,烧伤再生医疗技术比磺胺嘧啶银霜抗炎疗法更有利于减轻烧伤对患者体液的影响以及液体复苏、稳定有效血容量和改善预后。

Objective To compare the influences of different wound treatment therapies on body fluid and resusci- tation of burns at the shock stage. Methods Severe burned patients with a TBSA between 30% -90% were enrolled ran- domly to receive Moist Exposed Burn Therapy （MEBT） （Group A with 30 patients） and the traditional antibiotic therapy ofSD-Ag （ Group B with 30 patients） respectively. The body fluid changes and resuscitation condition of the two groups were analyzed by computer stimulation and the therapeutic effects were compared. Results Group A was obviously lower than Group B in terms of the fluid replacement volume, the net increase of body weight （ edema）, mean hospitalization time, medical expenses and the incidence of systemic infectious sepsis, and the differences were all significant in statistics （P 〈 0. 05 ）. Though the urine volume in Group A was higher than that in Group B and the incidence of shock signs in the former was lower than that in the latter, their differences had no significance in statistics （ P 〉 0. 05 ）. Conclusion In the treat- ment of severe burns, different wound treatment therapies will have different influences on the body fluid changes at the shock stage, resuscitation and prognosis. Compared with SD-Ag therapy, MEBT is a better therapy in that it can reduce the impairment of burns on patients＇ body fluid and resuscitation, stabilize the effective blood volume and improve the prognosis.