严重烧伤患者早期短程足量应用高效抗生素的研究

Effect of Early-starting,Short-term and Enough-dosage Administration of Power Antibiotics in Serious Burn Patients

目的 控讨早期短程足量应用高效抗生素对伤后患者感染的治疗效果。方法 烧伤患者 60例 ,烧伤面积 5 0 %～95 %。根据高效抗生素使用时机分为早防组 ( 3 5例伤后 6h内开始 )和后迟防组 ( 2 5例伤后 48h开始 )。动态检测血浆内毒素 (LPS) ,肿瘤坏死因子 (TNF -a)和白细胞介素 -8(IL -8)的变化 ,严密观察内脏并发症和脓毒症各项指标。结果 大面积烧伤后血LPS ,TNF -a和IL -8明显升高 ,于伤后 3～ 5d达高峰 ,但早防组明显低于迟防组 (P <0 0 0 1)。伤后 2周内脓毒症 ,内脏并发症的发生率 ,早防组明显低于迟防组 (P <0 0 0 1)。结论 严重烧伤早期短期足量使用高效抗生素能有效预防烧伤后感染 ,并可降低内脏并发症的发生。

Objective To investigate the effect of early starting,and short term and enough dosage administration of power antibcotics in the burn patients with infection.Methods 60 patients with burn surface area vary from 50% to 95% were investigated.According to the duration between burn and starting dose,these patients were divided into early administration group(35 cases, within 6 hours administration after burn)and late administration group(25 cases, starting administrating not later than 48 hours).Serum concentrations of LPS,TNFα and IL-8 were measured continuously.Visceral complications and index of septicopyemia were observed.Results Serum concentrations of LPS,TNFα and IL-8 were significantly elevated after large surface area burn,and reached a peak after 3 to 5 days.But their concentrations in early administration group was lower than that in late administration group(P<0 001).Rate of septicopyemia and visceral complications at two weeks after burn in early administration group was lower than that in late administration group(P<0 001).Conclusion Early starting ,short term and enough dosage administration of power antibiotics in serious burn patients can prevent infection,and prevent visceral complications as well.