评估不同程度的肝病烧伤患者的复苏情况
Habib Abla1, Vivie Tran1, Alan Pang1
1Texas Tech University Health Sciences Center, School of Medicine, 3601 Fourth Street, School of Medicine, MS6207, Lubbock 79430, TX, USA.
Burns : journal of the International Society for Burn Injuries
|February 17, 2024
概括
患有肝病的患者需要烧伤复苏,需要量身定制的液体治疗. 肝病严重程度增加与尿量减少相关,表明需要修改复苏策略,超出目前的烧伤大小和深度评估.
科学领域:
- 医学研究 医学研究
- 烧伤护理 烧伤护理
- 肝病学 肝病学是一种肝病学.
背景情况:
- 有限的文献存在于前存在肝病的烧伤患者的液体复苏.
- 目前的烧伤复苏方案缺乏针对肝脏病患者的具体指导方针.
研究的目的:
- 在有肝病史的患者中评估烧伤严重程度.
- 评估肝病严重程度与液体复苏需要之间的关系.
- 为了分层复苏疗法作为燃烧冲击严重程度的指标.
主要方法:
- 对314名成年烧伤患者进行了回顾性研究,烧伤量>=20%的总体表面积 (TBSA).
- 肝脏疾病的严重程度是通过入院的末期肝脏疾病模型 (MELD) 评分来确定的.
- 用24小时尿液输出测量复苏充分性;使用多变量线性回归分析.
主要成果:
- 在烧伤患者中,增加的MELD得分与减少的24小时尿量显著相关.
- 肝病的严重程度是尿量下降的更强的预测因素,而不是烧伤大小或深度.
- 对混因子的控制证实了MELD得分和尿液输出之间的反向关系.
结论:
- 肝病患者的烧伤严重程度受到肝功能独特的影响.
- 标准化复苏可能对严重肝病的烧伤患者不够.
- 需要进一步的研究来开发修改后的复苏方案,并为这一患者群体确定替代标志物.
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