甘露醇联合呋塞米在大面积烧伤后补液量充足患者中的应用效果分析

Effect of Mannitol combined with Furosemide in Patients with adequate Fluid Infusion after extensive Burns

目的探讨大面积烧伤后补液量充足患者采用甘露醇联合呋塞米治疗的临床效果。方法选取2021年1月至2023年7月商丘市第一人民医院烧伤整形外科收治的共计119例大面积烧伤后补液量充足患者,以随机数字表法分成研究组(n=59)和对照组(n=60),对照组给予呋塞米治疗,研究组给予甘露醇联合呋塞米治疗,比较两组肾功能、炎症因子、不良事件、气管切开发生率。结果治疗后两组均血肌酐(Scr)水平下降,24 h尿量增多,研究组Scr水平较对照组更低,24 h尿量更多,差异有统计学意义(P<0.05);两组治疗前后尿素氮(BUN)水平比较差异无统计学差异(P>0.05);治疗后两组降钙素原(PCT)、C反应蛋白(CRP)水平均下降,且研究组较对照组更低,差异有统计学意义(P<0.05);研究组不良事件发生率为6.78%(4/59),较对照组的25.00%(15/60)更低,差异有统计学意义(P<0.05);研究组气管切开率为20.34%(12/59),较对照组的40.00%(24/60)更低,差异有统计学意义(P<0.05)。结论甘露醇联合呋塞米应用于大面积烧伤后补液量充足患者治疗中,能够改善肾功能,减轻炎症反应,降低不良事件发生率及气管切开率。

Objective To explore the clinical effect of using mannitol combined with furosemide in the treatment of patients with adequate fluid infusion after extensive burns.Methods A total of 119 patients with adequate fluid infusion after extensive burns admitted to the burn and Plastic surgery department of the First People's Hospital of Shangqiu City from January 2021 to July 2023 were divided into study group(n=59)and control group(n=60)using a random number table method.The control group was treated with furosemide,while the study group was treated with mannitol combined with furosemide.The renal function,inflammatory factors,adverse events,and incidence of tracheostomy in the two groups were compared.Results After treatment,both groups had a decrease in blood creatinine(Scr)levels and an increase in 24-hour urine output.The Scr level in the study group was lower than that in the control group,and there was more 24-hour urine output,with a statistically significant difference(P<0.05);There was no statistically significant difference in blood urea nitrogen(BUN)levels between the two groups before and after treatment(P>0.05);After treatment,the levels of procalcitonin(PCT)and C-reactive protein(CRP)decreased in both groups,and the study group was lower than the control group,with statistical significance(P<0.05);The incidence of adverse events in the study group was 6.78%(4/59),which was lower than the control group's 25.00%(15/60),and the difference was statistically significant(P<0.05);The tracheotomy rate in the study group was 20.34%(12/59),which was lower than the control group's 40.00%(24/60),and the difference was statistically significant(P<0.05).Conclusion The combination of mannitol and furosemide in the treatment of patients with adequate fluid infusion after extensive burns can improve renal function,alleviate inflammatory reactions,reduce the incidence of adverse events and tracheostomy.