采用多变量分析估算休克期切痂烧伤患者休克期补液量

Estimating the fluid supplement amount of burn patients with escharectomy in shock stage by multivariate analysis

目的 :通过回顾性资料采用多元回归的统计方法拟合成多变量分析对临床休克期切痂围手术期补液量进行预测性分析。方法 :搜集 1991～ 1998年 30例临床资料较为完整的施行休克期切痂的大面积烧伤患者资料 ,根据患者入院时的临床和实验室检查选取多种观察变量对休克期切痂患者手术前和手术后补液量进行多元回归 ,拟合回归方程并进行统计学检验。同时用第三军医大学烧伤补液公式计算手术前补液量与回归方程所计算的补液量进行比较。结果 :经过回归方程 ,可以通过烧伤患者入院时的烧伤面积、年龄、心率、尿量、血红蛋白和红细胞压积预测患者休克期切痂前的补液量 ,同时根据术前补液量和切痂时间预测术后补液量。根据回归方程计算的补液系数为 1 75 7,大于第三军医大学公式 ,与我科临床目前使用的系数 1 8相近。结论 :采用回顾性的资料估算休克期切痂患者休克期内的补液量 ,考虑了与患者循环状况有密切关系的烧伤面积之外的其他因素如尿量、血红蛋白和红细胞压积等 ,便于更全面的预计患者的液体需要量 。

Objective:To estimate the amount of fluid supplement of burn patients with escharectomy during shock stage by multiple regression with retrospective data Methods:The clinical data of 30 major burn patients, who were treated by escharectomy during shock stage from 1991 to 1998, were collected Various variables selected according to the clinical and laboratory examinations of patients on admission, were gathered to process the multiple regression for estimating the fluid supplement before and after operation At the same time the fluid supplement calculated by the formula of the Third Military Medical College was compared to that of our regression Results:According to our regression, the fluid supplement of burn patients who will be carried escharectomy during shock stage may be estimated by the burn area, heart rate, urine amount, hemoglobin and HCT of patients The coefficient calculated by our regression was 1 757, which was higher than that of the formula of the Third Military Medical College,but similar to that of our clinical application, 1 8 Conclusion:The advantage of estimating the amount of fluid supplement in burn patients with escharectomy during shock stage by regression is to consider the various factors related to the circulation of patients Such method can estimate the amount of fluid supplement more comprehensively and facilitate the clinical doctors to master the fluid supplement of burn patients during shock stage