上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (1): 64-.doi: 10.3969/j.issn.1674-8115.2011.01.015

• 论著（临床研究） • 上一篇    下一篇

烧伤创面深度对患者休克期补液量的影响

陈郑礼, 袁克俭   

  1. 上海交通大学 医学院附属瑞金医院灼伤整形科, 上海 200025
  • 出版日期:2011-01-28 发布日期:2011-02-01
  • 作者简介:陈郑礼(1984—）, 男, 住院医师, 硕士；电子信箱: chenzhengli@medmail.com.cn。

Influence of depth of burn wound on volume of fluid infusion during shock stage

CHEN Zheng-li, YUAN Ke-jian   

  1. Department of Burns, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2011-01-28 Published:2011-02-01

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摘要：

目的 探讨烧伤创面深度与患者休克期补液量的相关性。方法 收集烧伤面积≥25％总体表面积（TBSA）且休克期采用瑞金公式进行液体复苏患者的病史资料。记录入选患者的体表烧伤总面积、Ⅲ度烧伤面积以及烧伤后第1个和第2个24 h的补液量；计算Ⅲ度烧伤创面面积与体表烧伤总面积的比值（Ⅲ度创面比），换算烧伤后第1个和第2个24 h的实际补液系数（VIWB）；分析Ⅲ度创面比与VIWB的相关性，建立回归方程并换算烧伤后第1个和第2个24 h 的修正VIWB。结果 166例患者资料入选。与单纯Ⅱ度烧伤患者（n=53）比较，单纯Ⅲ度烧伤患者（n=7）烧伤后第1个和第2个24 h 的VIWB分别增加了37%和41%（均P<0.05）。Ⅲ度创面比与烧伤后第1个和第2个24 h 的VIWB均呈显著正相关（R2=0.138，P<0.001；R2=0.108，P<0.001）；建立的回归方程为y=0.537x+1.595和y=0.314x+0.775。与相同面积的Ⅱ度烧伤创面比较，Ⅲ度烧伤创面烧伤后第1个和第2个24 h的修正VIWB分别增加了35%和41%；Ⅲ度创面比每提高20%，第1个和第2个24 h的VIWB-修正公式需分别增加0.1和0.06。结论 烧伤患者休克期补液量与Ⅲ度创面比有关；修正公式适用于不同深度烧伤创面VIWB的换算。

关键词: 烧伤, 休克, 补液治疗, 创面深度

Abstract:

Objective To explore the relationship between depth of burn wound and volume of fluid infusion during shock stage. Methods The clinical data of patients with total burn surface area no less than 25% of total body surface area and undergoing fluid infusion by Ruijin resuscitation formula during shock stage were collected. The total burn surface area, full-thickness burn surface area and volumes of fluid infusion in the first and second 24 h after burn were recorded, the ratio of full-thickness burn surface area to burn surface area (full-thickness burn surface area ratio) was calculated, and volumes infused per body weight and burn surface area （VIWB）in the first and second 24 h after burn were obtained. The relationship between full-thickness burn surface area ratio and VIWB was explored, the regression equations were established, and the corrected VIWB in the first and second 24 h after burn were calculated. Results The data of 166 patients were included. Compared with VIWB of patients with superficial burn （n=53）, those of patients with fullthickness burn （n=7） increased 37% and 41% in the first and second 24 h after burn, respectively (P<0.05). Fullthickness burn surface area ratio was significantly positively related to VIWB in the first and second 24 h after burn (R2=0.138, P<0.001; R2=0.108, P<0.001). The regression equations were y=0.537x+1.595 and y=0.314x+0.775. Compared with corrected VIWB in the first and second 24 h after burn of patients with superficial burn, those of patients with full-thickness burn and same burn surface area increased 35% and 41%, respectively. With each 20% increase in full-thickness burn surface area ratio, the corrected VIWB in the first and second 24 h after burn increased 0.1 and 0.06, respectively. Conclusion Full-thickness burn surface area ratio is related to volume of fluid infusion during shock stage, and corrected formula is suitable to VIWB of different depth of burn wound.

Key words: burn, shock, fluid therapy, depth of wound