嚴重烧伤休克期不同时间段体液代谢失调的临床研究.docVIP

严重烧伤休克期不同时间段体液代谢失调的临床研究 孙业祥 唐益忠 吴雪生 [摘要] 目的：探讨严重烧伤休克期不同时间段体液代谢失调的变化规律与防治措施。方法：对1996年1月至2006年12月间住院的169例重度以上烧伤病人休克期不同时间段的359次的同步血气与电解质的结果进行回顾性分析。结果：（1）血清钠离子在0h～8h、816h及16h～24h无显著性差异，P0.01）。（2）血清钾离子在在0h～8h、816h、24h～48h及48h～72h明显降低，与对照组相比较有极显著性差异（P0.01），在16h～24h无显著性差异。（3）血清碳酸氢根离子在0h～8h、816h、16h～24h、24h～48h及48h～72h明显降低，与对照组相比较有极显著性差异（P0.01）。（4）血清AG在0h～8h、816h、16h～24h、24h～48h及48h～72h明显增高，与对照组相比较有极显著性差异（P0.01）。（5）全组患者除次酸碱失衡类型属正常外，其余27次中，单纯性酸碱失衡类型次, 其中以性中毒（）最多；双重性1次，以呼吸性碱中毒并代谢性碱中毒（代碱）为主；三重性6次，以呼吸性碱中毒并代谢性酸中毒并代谢性碱中毒为主。（）伤后0h～8h、8～16h、16～24h、24～48h和48～72h所发生的酸碱失衡类型不同，其最多见的类型分别是代谢性酸中毒、呼吸性酸中毒（呼酸）并代谢性酸中毒、呼吸性碱中毒、呼吸性碱中毒呼吸性碱中毒并代谢性碱中毒。～与呈相关严重烧伤休克期不同时间段的酸碱失衡类型比较复杂，烧伤后24h内以酸中毒为主，24h后以碱中毒为主三重性酸碱失衡，伤后～8h以呼酸型三重性酸碱失衡为主，48h后以呼碱型三重性酸碱失衡为主。 Study of Electrolyte and Acid-Base disturbances at Different Phase of Shock Stage of Severe Burns SUN Ye-xiang, TANG Yi-zhong, et al. Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, P.R.China [Abstract] Objective: To explore the dynamical change，prevention and treatment of serum electrolyte and acid-base disturbances at different phase of shock stage of severe burns. Methods: 159 hospitalized patients with severe burn injury were collected in the period of 1/1996-31/2006. A retrospective assessment on the patients’ 359 times synchronous blood gas and electrolyte analysis results was made. Results: 1. During 0h～～～erum Na+ value was no significant difference between the treatment group and control group. But during 24h～～(P0.01). 2. During 0h～～～～erum K+ value was reduced significantly in the treatment groups, compared with the control group, there was a very significant difference (P0.01), But during 16h～significant difference between the treatment group and control group. 3. During 0h～～～～～erum HCO3- value was reduced significantly in the treatment groups, compared with the control group, there was a very significant difference (P0.01). 4. During 0h～～～～～he serum AG value was significantly high