高原地区小儿烧伤休克液体复苏的治疗研究进展

Progress in Fluid Resuscitation Treatment of Burn Shock in Children in Plateau Region

小儿烧伤是儿童受伤相关发病率和死亡率的主要原因,在我国,小儿烧伤居意外伤害排名第三位,仅次于交通事故和溺水。烧伤后毛细血管受损,微血管通透性增加,血管内液外渗,组织水肿,微循环灌注不良,从而导致休克。抗休克的重要手段是液体复苏,能否科学有效地补液,使患者平稳度过休克期,可直接影响患者的救治成功率。高原气候的独特特点是寒冷、干燥,紫外线辐射强,风沙大,空气相对湿度较低,所以在高原地区烧伤休克液体复苏中,不仅要考虑补液公式,更要参考环境条件、缺氧等因素的影响,目前,虽然液体复苏方案较成熟,但高原地区小儿烧伤休克的发病机制较为复杂,致使小儿烧伤休克的治疗难度仍较大。因此,本研究将从烧伤休克液体复苏补液公式、复苏成分、复苏检测指标等方面进行综述。

Children’s burn is the main cause of morbidity and mortality related to children’s injuries. In our country, children’s burn ranks the third among accidental injuries, only second to traffic accidents and drowning. After burn, capillaries are damaged, microvascular permeability increases, intra-vascular fluid extravasation, tissue edema, poor microcirculation perfusion, resulting in shock. The important means of anti-shock is fluid resuscitation, whether the fluid can be replenished scientifically and effectively to make the patients survive the shock period smoothly, can directly affect the success rate of treatment of patients. The unique characteristics of plateau climate are cold, dry, strong ultraviolet radiation, heavy wind and sand, and low relative humidity of air. Therefore, in fluid resuscitation of burn and shock in plateau areas, not only the formula of fluid replacement should be considered, but also the influence of environmental conditions, hypoxia and other factors should be considered. At present, although the liquid resuscitation program is mature, the pathogenesis of burn and shock in children in plateau areas is complicated. The treatment of burn shock in children is still more difficult. Therefore, this study will be summarized from the formula of fluid resuscitation for burn shock fluid, resuscitation components, and resuscitation detection indicators.