| objectiveTo explore the value and numerical scope of Potential of Hydrogen, Standard Bicarbonate, arterial carbon dioxide pressure, base excess, lactic acid and arterial oxygen pressure from the blood gas analysis and acid-base imbalance analysis in the early stage of the clinical treatment of patients with massive burn injury,To provide a reference for clinical work.methodsAccording to the inclusion and exclusion criteria, clinical data of 59 patients with massive burn injury admitted to the First Affiliated Hospital of Guangxi Medical University from December 2010 to September 2014 was collected and was then divided into two groups, the death group and survival group. Statistical analysis was performed on the indexes of Potential of Hydrogen, Standard Bicarbonate, arterial carbon dioxide pressure, base excess, lactic acid and arterial oxygen pressure of the two groups of patients. Data was processed with t test, chi-square test.Results1、8 hour period after injury, the arterial blood PH of the death group was(7.24±0.08), while the survival group was(7.31±0.09); After a period of 24 hours, the arterial blood PH of the death group was(7.28±0.11), while that of the survival group was(7.35±0.08); 48 hours period after injury, the arterial blood PH of the death was(7.36±0.13), getting almost to the normal range, and that of the survival group was(7.41±0.04). The difference in PH between the two groups was statistically significant at each particular time. It could be observed that, 48 hours period after injury, the mortality rate of the patients with normal PH value was 10.0%, while the mortality rate was 40.0% when the PH value was greater than 7.45, the mortality difference of the two groups of patients was statistically significant.2、8 hours period after injury, the arterial blood SB of the death group was(16.5±2.8)mmol/L, while the survival group was(18.6±3.8)mmol/L; After a period of 24 hours, the arterial blood SB of the death group was(17.4±4.1)mmol/L, and that of the survival group was(20.4±3.6)mmol/L; The difference of the SB values of the two groups was statistically significant(P < 0.05). 48 hours period after injury, the arterial blood SB of the death group was(21.7±6.1)mmol/L, while the arterial blood SB in the survival group was(23.3±2.7)mmol/L. There was no significant difference between the two groups(P>0.05). It was observed that, 48 hours period after injury, the mortality rate of the patients with SB more than 27mmol/L was at 50.0%, while the mortality rate was 11.8% when the SB value was normal in patients, the difference in the mortality rate of the two groups was statistically significant.3、8 hours period after injury, there was no statistical difference in the mortality rate between patients with PaCO2 <35mmHg and patients with normal PaCO2 values, while, for the other time periods, the difference in the mortality rate between patients with PaCO2 <35mmHg, or PaCO2 >45mmHg and with patients with normal PaCO2 values was statistically significant.4、8 hour period after injury, the arterial blood BE of the death group was(-10.5±4.4)mmol/L, while the survival group was(-7.5±4.3)mmol/L; After a 24 hour period, the arterial blood BE of the death group was(-8.5±4.6)mmol/L, and that of the survival group was(-4.9±3.8)mmol/L; 48 hour period after injury, the arterial blood BE of the death group was(-3.5±5.7)mmol/L, while that of the survival group was(-1.0±2.8)mmol/L. The difference in the BE values of the two groups over each time period was statistically significant(P < 0.05).5、After an 8 hour period, the arterial blood lactic acid of the death group was(5.3±2.3)mmol/L, while the survival group(4.3±1.9)mmol/L; After a 24 hour period, the arterial blood lactic acid of the death group recovered to(4.5±2.9)mmol/L, while that of the survival group was at(3.3±1.8)mmol/L; After a 48 hour period after injury, the arterial blood lactic acid of the death group recovered to(3.5±1.4)mmol/L, and that of the survival group was(2.5±1.3)mmol/L. The difference in the lactic acid values of the two groups over each time period was statistically significant(P < 0.05).6、After a 24 hour and 48 hour period after injury, there was statistical difference in the mortality rate in between patients with PaO2 < 80 mmHg and in patients with normal PaO2. There was no statistical difference in the mortality rate in each time period where the patients had normal PaO2 when compared either with patients with PaO2 < 80 mmHg, or in patients with PaO2 >100 mmHg.Conclusion1、For patients with large area of burns, at the 8 hour period after injury, a PH value less than 7.3 indicates that the patient’s condition is severe, and the mortality rate is higher. The treatment given within the 24 hour period after injury has an obvious influence on the prognosis. It has been observed that up until the 48 hour period after injury, there is an increase in the number of patients with alkaline PH, and having a higher mortality rate, we should thus pay attention to this.2、For patients with large area of burns, it has been observed that an SB value above 18.5 mmol/L at the 8 hour period, and an SB value maintained at more than 20 mmol/L at the 24 hour period after injury can effectively reduce the mortality rate; but patients with SB value more than 27 mmol/L at the 48 hour period after injury have higher mortality rates, and needs total attention in that context.3、For patients with large area of burns, hypoxemia and hypercapnia have an important influence on the prognosis. It is better to timely and effectively improve the respiratory alkalosis after 24 hours.4、For patients with large area of burns, the patient’s arterial blood BE content is related with the mortality rate. At the 8 hour period after injury, a BE level above-7.5mmol/L and a BE level of more than-5mmol/L at the 24 hour period can improve prognosis;5、For patients with large area of burns, the arterial blood lactic acid levels of the patients are associated with mortality. After treating the wounds and at the 24 hour period, keeping the lactic acid levels under control at less than 3.5 mmol/L, can effectively reduce the mortality rate. |
PDF Full Text Request