摘要
目的分析严重烧伤早期动脉血碱缺失水平的变化及其临床意义。 方法回顾 12 6例烧伤面积 >30 %的患者伤后 48h内碱缺失 (BD)值的动态变化 ,比较存活者和死亡者BD值的变化及BD与烧伤总面积 (TBSA)之间的关系。 结果烧伤早期 48h内BD逐渐升高 ,存活组伤后 4～ 8hBD显著提高 (P <0 .0 5 ) ,死亡组伤后 16～2 4h才明显提高 (P <0 .0 5 ) ,两组在伤后 4～ 8hBD差异显著 (P <0 .0 1)。伤后 48h内存活组BD与TBSA均无明显相关性 ,而死亡组伤后 4～ 16hBD与TBSA显著相关 (P≤ 0 .0 5 )。死亡组的器官衰竭发生率亦明显高于存活组。结论严重烧伤早期BD可作为烧伤早期液体复苏时的监测指标之一 ,目前采用的瑞金补液复苏方法能有效改善烧伤早期组织器官的低灌注状态。若在此治疗过程中 ,伤后 4～ 16hBD仍持续低水平可能提示预后不良。
Objective To investigate the changes of arterial base deficits (BD) in the early stage of extensive burned patients. Methods We perform a retrospective review of 126 patients with a total body surface area (TBSA) over 30% whose resuscitations were initiated with the Ruijin formula to observe the BD changes and analyze the relationship of BD and TBSA at different postburn time intervals in survivors and deaths. Results Within 48h after burn injury, the BD value improved gradually. The difference between survivors and nonsurvivors was significant at 4 to 8h interval after burn injury (P<0.05). BD was correlated with TBSA strongly during 4 to 16h after burn injury (P≤0.05)in nonsurvivors, but not in survivors. The incidence of the shock-related complications in survivors was higher than in nonsurvivors. Conclusion BD could be one of monitor index in the shock stage after severe burn injury.
出处
《上海第二医科大学学报》
CSCD
2000年第6期524-526,共3页
Acta Universitatis Medicinalis Secondae Shanghai
关键词
烧伤
休克
复苏
碱缺失
burn
shock
resuscitation
base deficit
