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目的:对比传统公式计算量与实际补液量,总结高海拔地区84例小儿大面积烧伤患者休克期补液复苏经验。方法:收集84例小儿大面积烧伤患者休克期补液临床资料,分为两组,A组:1990年—2000年45例,按照传统烧伤公式计算量补液;B组:2000年—2008年39例,在传统烧伤公式计算量的基础上,根据患者实际需要进行补液。通过观察两组休克期补液量及尿量,分析总结休克期补液疗效。结果:第一个24小时,B组患者液体总入量(4 550±520)mL明显多于A组(3 740±480)mL,差异有统计学意义,P<0.01。两组患者每小时尿量比较,A组(37±11)mL少于B组(41±10)mL,差异有统计学意义,P<0.05。第二个24小时,B组患者液体总入量(3 853±326)mL多于A组(2 980±305)mL,差异有统计学意义,P<0.05。两组患者每小时尿量比较,差异无统计学意义,P>0.05。结论:青海地处高海拔地区,气候干燥,烧伤患儿不论面积大小其不显性失水均增多,气管切开插管患者丢失量更大,抗休克治疗应增加液体的补充才能平稳度过休克期。
OBJECTIVE: To compare the calculation of conventional formula with the actual volume of fluid replacement, and to summarize the experience of rehydration during shock recovery in 84 cases of children with extensive burns in high altitude areas. Methods: The clinical data of 84 patients with massive burn in children during shock stage were collected and divided into two groups. Group A: 45 cases from 1990 to 2000 were calculated according to the traditional burn formula. Group B: 39 cases from 2000 to 2008 , Based on the traditional calculation of burn formula, according to the actual needs of patients rehydration. By observing the two groups of fluid volume and urine volume during shock, analyze the effect of fluid replacement during shock. Results: In the first 24 hours, the total amount of fluid in group B (45 550 ± 520) mL was significantly higher than that in group A (3740 ± 480) mL, the difference was statistically significant (P <0.01). The urinary output per hour in both groups was significantly lower than that in group B (37 ± 11) mL (41 ± 10) mL, P <0.05. In the second 24 hours, the total volume of fluid in group B was more than that of group A (2,985 ± 305) mL, with a significant difference (P <0.05). There was no significant difference in urinary output per hour between the two groups (P> 0.05). Conclusion: Qinghai is located in the high altitude area, the climate is dry, the irrespective of the size of the children with burns, their insubstantial water loss is increased, the amount of tracheotomy intubated patients lost more anti-shock treatment should be increased liquid supplement to be smooth Shock period