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中华妇幼临床医学杂志(电子版) ›› 2008, Vol. 04 ›› Issue (06) : 550 -554. doi: 10.3877/cma.j.issn.1673-5250.2008.06.109

论著

小儿重度烧伤休克延迟复苏的临床研究
谭嘉韬, 陈锋, 李巍, 李伟, 李峥, 何小龙   
  1. 四川省医学科学院、四川省人民医院烧伤外科(成都,610072)
  • 出版日期:2008-12-01

A Clinical Study on the Treatment of Delayed Resuscitation of Children With Severe Burn Shock

Jia-tao TAN, Feng CHEN, Wei LI, Wei LI, Zheng LI, Xiao-long He   

  1. Department of Burn Surgery, Sichuan Academy of Medical Science and Provincial People's Hospital, Chengdu 610072, China
  • Published:2008-12-01
引用本文:

谭嘉韬, 陈锋, 李巍, 李伟, 李峥, 何小龙. 小儿重度烧伤休克延迟复苏的临床研究[J]. 中华妇幼临床医学杂志(电子版), 2008, 04(06): 550-554.

Jia-tao TAN, Feng CHEN, Wei LI, Wei LI, Zheng LI, Xiao-long He. A Clinical Study on the Treatment of Delayed Resuscitation of Children With Severe Burn Shock[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2008, 04(06): 550-554.

目的

探讨提高小儿重度烧伤休克延迟复苏抢救成功率,评价改进休克复苏方案对重度烧伤休克患儿延迟复苏的治疗效果。

方法

对2003年2月至2008年5月在四川省医学科学院、四川省人民医院烧伤科收治的58例重度烧伤因延迟复苏导致休克的患儿,进行快速补液复苏。监测患儿休克期补液量、尿量、脉搏、呼吸频率及等指标的变化。

结果

本组重度烧伤休克患儿快速补液后,各项观测指标均获改善,休克得到快速纠正。快速补液后2 h,输人液体占第1个24 h公式计算量的(41. 1± 4. 6)%,第1个24 h实际补入量占第1个24 h公式计算量的(153. 4±25. 6)%;第2个24 h实际补人量占第2个24 h公式计算量的(118. 6±6. 8)%。快速补液后,本组患儿尿量大幅增加,上升,未出现心、肺功能不全症状,休克纠正率为90%。

结论

快速、足量液体补充的复苏治疗,可迅速纠正患儿的延迟复苏重度烧伤休克。小儿重度烧伤休克延迟复苏,需要加快补液速率、加大补液量,静脉输液量不受输液公式的限制。

Objective

To study experiences and improve the treatment plan on delayed resuscitation of children with severe burn shock.

Methods

From February 2003 to May 2008, fifty-eight cases children patients who were in shock due to delayed admission to hospital with severe burn shock and were treatment in the Department of Burn Surgery, Sichuan Academy of Medical Science and Provincial People's Hospital were enrolled in the study. The children patients were treated by delayed rapid fluid replacement. The input of the fluid, urine output, pulse rate, respiration rate, and were monitored at the shock stage.

Results

After rapid fluid replacement, all children patients had remarkable increase in urine output, the indices of observation were all improved,and burn shock was corrected rapidly. The amount of rapid fluid infusion with 2 hours after admission accounted for(41. 1±4. 6)% of the amount calculated with the formula for the first 24 PBHs. The real amount of the infusion for the first 24 PBHs was(153. 4 ±25. 6)% more than that of the formula amount, and the real infusion fluid amount for the second 24 PBHs was(118. 6 ± 6. 8)% more than that of the formula amount. After rapid fluid infusion, there exhibited remarked increase in urine output, with evident increase. The shock rectify rate is 90%.

Conclusion

Rapid fluid replacement is effective treatment on delayed resuscitation of children with severe burn shock, and burn shock was corrected rapidly. In case of shock or compulsory delayed resuscitation, the amount of delayed rapid fluid infusion was much increased than routine.

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