CAJ | 학술논문

目的寻求危重烧伤早期简便、快速、有效的补液治疗方案.方法对2002-07～2009-07收治的15例危重烧伤患者立即行锁骨下深静脉置入中心静脉导管,以此作为快速补液通道,同时床旁安装简易中心静脉压(CVP)监测装置,根据CVP监测结果,结合尿量、心率、呼吸及意识等无创监测指标调节补液;计算伤后第1个24 h和第2个24 h补液量;根据补液公式:晶胶体总量＝面积×体质量×k,换算出k值(k为晶胶体系数).结果 15例危重烧伤患者休克期平稳度过.伤后第1个24 h补液总量为(10 963±1062)mL,晶体(5321±983)mL,胶体(4013±887)mL,5%葡萄糖(2754±753)mL,k＝1.7～2.0.第2个24 h输液总量为(8135±725)mL,晶体(3356±652)mL,胶体(2953±375)mL,5%葡萄糖(2584±804)mL,k＝1.3～1.5.结论中心静脉导管置入与中心静脉压监测运用于危重烧伤早期补液治疗,方法简便、疗效确切.
목적 심구위중소상조기간편、쾌속、유효적보액치료방안.방법 대2002-07～2009-07수치적15례위중소상환자립즉행쇄골하심정맥치입중심정맥도관,이차작위쾌속보액통도,동시상방안장간역중심정맥압(CVP)감측장치,근거CVP감측결과,결합뇨량、심솔、호흡급의식등무창감측지표조절보액;계산상후제1개24 h화제2개24 h보액량;근거보액공식:정효체총량＝면적×체질량×k,환산출k치(k위정효체계수).결과 15례위중소상환자휴극기평은도과.상후제1개24 h보액총량위(10 963±1062)mL,정체(5321±983)mL,효체(4013±887)mL,5%포도당(2754±753)mL,k＝1.7～2.0.제2개24 h수액총량위(8135±725)mL,정체(3356±652)mL,효체(2953±375)mL,5%포도당(2584±804)mL,k＝1.3～1.5.결론 중심정맥도관치입여중심정맥압감측운용우위중소상조기보액치료,방법간편、료효학절.
Objective To explore a convenient, quick and effective fluid replacement solution by the application of central venous catheterization and central venous pressure(CVP) in the early period of severe burn shock. Methods From July 2002 to July 2009, fifteen patients with severe burn was enrolled. After the patients were transferred to the ward, both central venous catheterization and central venous pressure (CVP) were carried out. According to the results of CVP, urine volume, heart rate, respiratory frequency and consciousness, the volume of fluid was calculated during the first 24 h and second 24 h. Fluid replacement formula lists were as follows;the total fluid volume=BSA( body surface area with burn) ×body weight ×k ( k is a coefficient). Results All the 15 cases recovered from burn shock. During the first 24th hour,the average fluid volume was (10 963±1062) mL[crystal solution was (5321± 983) mL,colloidal fluid was (4013±887) mL,k = 1. 7～2. 0. During the second 24 hour,the average fluid volume was (8135±725) mL [crystal solution was (3356±652)mL,colloidal fluid was (2953±375)mL, k= 1.3～1.5]. Conclusion Application of central venous catheterization and CVP monitoring is a effective method in treating the serious burn patients during early shock period.