| 王曌华,张 永,裴敬仲.目标导向液体治疗对大面积烧伤患者术后肺功能及氧平衡的影响[J].中国烧伤创疡杂志,2020,(5):344~347. |
| DOI： |
| 中文关键词: 目标导向液体治疗 大面积烧伤 切痂术 肺功能 氧平衡 |
| 英文关键词:Goal-directed fluid therapy Extensive burns Escharotomy Lung function Oxygen balance |
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| 中文摘要: |
| 目的 对比分析目标导向液体治疗对大面积烧伤患者切痂术后肺功能及氧平衡的影响。方法 选取2016年3月至2019年3月新乡市第二人民医院收治的100例大面积烧伤患者作为研究对象，并按照不同干预方法将其分为试验组和对照组，每组50例。切痂术中，试验组患者行目标导向液体治疗，对照组患者行常规液体治疗，对比两组患者术后第1、6、12小时的血管外肺水指数与全心舒张末期容积指数以及术后第6、12、24小时的氧合指数与血乳酸变化情况。结果 术后，两组患者血管外肺水指数及氧合指数均逐渐升高（试验组：F=5.315、27.932，P=0.006、0.000；对照组：F=5.731、6.006，P=0.004、0.003），全心舒张末期容积指数无明显变化（F=0.222、0.048，P=0.801、0.953），血乳酸水平逐渐降低（F=152.849、86.746，P均=0.000）。术后第6、12小时试验组患者血管外肺水指数均明显低于对照组（t=2.222、2.272，P=0.029、0.025），全心舒张末期容积指数与对照组均无明显差异（t=1.575、1.302，P=0.118、0.196）；术后第12、24小时试验组患者氧合指数均明显高于对照组（t=3.852、4.004，P均=0.000），血乳酸水平均明显低于对照组（t=4.303、18.471，P均=0.000）。结论 目标导向液体治疗能够有效提高大面积烧伤患者切痂术后的肺功能，改善患者的氧平衡状态。 |
| 英文摘要: |
| Objective: To analyze the effect of goal-directed fluid therapy on lung functions and oxygen balance of patients with extensive burns after the escharotomy. Methods: One hundred patients with extensive burns admitted into Xinxiang Second People’s Hospital between March 2016 and March 2019 were selected as subjects to be divided into an experimental group and a control group according to different interventions, 50 patients each group. During the escharotomy, the goal-directed fluid therapy was given to patients in the experimental group while the patients in the control group were given the regular fluid therapy. Extravascular lung water index and global end-diastolic volume index of patients at 1h, 6h and 12h post-operation, and the changes of oxygenation index and blood lactic acid of patients at 6h, 12h and 24 post-operation were compared between the two groups. Results: In the experimental group, the extravascular lung water indexes of patients at 6h and 12h post-operation were markedly lower than that in the control group (t=2.222 and 2.272, P=0.029 and 0.025), but there was no statistically significant difference between the two groups in terms of global end-diastolic volume index (t=1.575 and 1.302, P=0.118 and 0.196). At 12h and 24h post-operation, the oxygenation indexes of patients in the experimental group were obviously higher than that in the control group (t=3.852 and 4.004, both P=0.000), and the levels of blood lactic acid were markedly lower than that in the control group (t=4.303 and 18.471, both P=0.000). After the operation, the extravascular lung water index and oxygenation index of patients were gradually raised in the two groups (experimental group: F=5.315 and 27.932, P=0.006 and 0.000; Control group: F=5.731 and 6.006, P=0.004 and 0.003), the global end-diastolic volume index of patients in the two groups presented no significant changes (F=0.222 and 0.048, P=0.801 and 0.953), while the level of blood lactic acid gradually decreased in the two groups (F=152.849 and 86.746, both P=0.000). Conclusion: The goal-directed fluid therapy can effectively improve the lung functions of patients with extensive burns who underwent the escharotomy, and ameliorate the oxygen balance of such patients. |
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