52例严重烧伤休克期血流动力学变化监测

目的观察休克期血流动力学监测对复苏的指导意义。方法采用血流动力学监测仪，对我科１９８５～１９９６年烧伤总面积在（６９９±２０１）％，Ⅲ度面积（６０４±１３６）％，且人院后均置入ＳｗａｎＧａｎｚ飘浮导管的５２例烧伤病人的右房压（ＲＡＰ）、肺动脉压（ＰＡＰ）、肺动脉楔嵌压（ＰＡＷＰ）、心率（ＨＲ）、心排量（ＣＯ）、心排指数（ＣＩ）、每搏指数（ＳＩ），于入院时及伤后８，１６，２４，４８，７２，９６ｈ进行了动态监测。结果休克期实施有创血流动力学监测是安全的，无一例发生并发症；休克病人在烧伤后２４ｈ各项血流动力学指标基本恢复了正常。结论烧伤休克期实施有创血流动力学监测对指导复苏具有重要意义。

Hemodynamic monitoring in 52 serious burn patients in ten years

Objective\ To determine the benefit of hemodynamic monitoring for resuscitation of burn shock. Methods\ A group of 52 burned patients with mean burn area of (69.920.1)% TBSA burn injury (range 310%),and mean burn area of (60.413.6)% TBSA were included in this study.SwanGanz catheters were inserted to monitor hemodynamics including RAP,PAP,PAWP,HR,CO,CI,and SI,etc.after admission at 8,16,24,36,48,72,and 96 hours postburn. Results\ It was reasonably safe to perform invasive minitoring during early resuscitation.With the guide of hemodynamic monitoring,evidence of global hypovolemia disappeared at 24 hours after burn injury with appropriate resuscitation therapy. Conclusion\ Invasive hemodynamic monitoring may be necessary to optimize resuscitation of serious burn patients with reasonable safety.