大面积烧伤患者感染期综合治疗并发高钠血症的临床研究

Clinical study on comprehensive treatment for patients with extensive burns complicated by hypernatremia in infection stage

目的探讨综合治疗大面积烧伤患者感染期并发高钠血症的临床疗效,以降低病死率。方法随机选取2012年3月-2014年9月医院收治的35例大面积烧伤感染期患者作为研究对象,根据入院时间先后将患者分成观察组18例和对照组17例,对照组患者采用常规护理治疗,观察组患者采用综合护理治疗,观察并记录两组患者临床疗效及各项生理指标,并进行分析比较。结果脓毒症患者分布率观察组为72.22%,对照组为76.47%,两组比较差异无统计学意义;患者治疗48h后,观察组患者心率、血钠、尿素氮及肌酐含量均显著下降,对照组患者无明显变化,除白细胞计数外,两组患者各项生理指标比较差异有统计学意义(P<0.05);经治疗后,观察组患者死亡6例,总有效率为44.44%,对照组患者死亡11例,总有效率为17.65%,两组比较差异有统计学意义(P<0.05)。结论采用综合护理治疗大面积烧伤并发高钠血症患者能取得相对较好疗效,患者临床症状得到改善,各项生理指标有显著变化,病死率降低,预后较好。

OBJECTIVE To study the clinical efficacy of comprehensive treatment of extensive burns complicated by hypernatremia in infection stage so as to reduce mortality .METHODS Totally 35 cases of extensive burns in infec‐tion stage during Mar .2012 to Sep .2014 were selected as research subjects and divided into the observation group of 18 cases and the control group of 17 cases according to admission time .The control group was treated with rou‐tine care and the observation group was treated with comprehensive care .Clinical efficacy and various physiological indicators were observed and recorded in the two groups for analysis and comparison .RESULTS The distribution of sepsis was 72 .22% in the observation group and 76 .47% in the control group .After 48 h of treatment ,heart rate ,blood sodium ,blood urea nitrogen and creatinine contents in the observation group were significantly de‐creased while the control group of patients did not show significant changes .Except for white blood cell count , differences in physiological parameters between the two groups of patients were significant （P〈 0 .05） .After treatment ,there were 6 deaths in the observation group with the total effective rate of 44 .44% and 11 deaths in the control group with the total effective rate of 17 .65% （P〈0 .05） .CONCLUSION Comprehensive care in trea‐ting extensive burns complicated with hypernatremia can achieve relatively good efficacy ,improving clinical symp‐toms ,significantly changing the physiological indicators and reducing mortality and the prognosis is good .