小儿特大面积烧伤的休克与补液治疗

Shock and Fluid Therapy of Seriously Burned

小儿大面积烧伤,特别是总面积在50%以上者,其休克和死亡率均显著增加.今报告15年来收治的12岁以下、烧伤总面积在50%以上的病例,并就其休克期的补液治疗等有关问题进行讨论.

Thirty-eight children with burns of more than 50% TBSA were treated between march,1970 and Feb,1985.The incidence of burn shock was 94.7%.The authors state that both shock (34.5%) and infection (38.4%) are the important causes of death in severe burns,so the anti-shock treatment should be initiated within an hour of injury. The average survival rate was 41.3% in children with burn of 50-70% of body surface and the 7-12yr group had a higher survival rate (66.2%).In these cases the amount of fluid infusion during the second 24 hours was about 75 per cent of the finst 24 hours.In treating children with respiratory burns fluid infusion should not be restricted.Problems involved the hypertension during the early stage and the treatment of 'refractory shock' are discussed.