Objective To analyze the clinical data of adult patients with total burn surface area (TBSA) greater than 50% in Guangzhou and explore the optimal fluid resuscitation protocols for these patients.Methods The clinical data of 94 adult patients with a TBSA over 50% treated in our center during 1991-2010 were reviewed,and the former decade.Fluid resuscitation volume of various components in shock stage,urine volume,occurrence of visceral complications and mortality rate withinlO days after injury were compared between patients treated in 1991-1999 and those in 2000-2010.Results The first 24-h crystalline colloidal fluid ratio,first 24-h infusion volume and the second 24-h crystalloid fluid coefficients were significantly greater in the patients treated in 2000-2010 than in those treated in 1991-1999.The visceral complications and mortality rate were significantly lower in the latter than in the former patients (7.69% vs 27.3% and 2.56% vs 18.18%,respectively,P<0.05).Conclusion For patients with extensive burns,an individualized fluid resuscitation regimen,an adequately high colloid/crystal rehydration ratio,and a greater total infusion volume according to the local climate of Guangzhou can be beneficial to reduce the incidence of visceral complications and the mortality rate.%目的 回顾性分析近20年烧伤总面积≥50％成人烧伤患者早期液体复苏资料,探讨适合广州地区严重烧伤休克期补液方案.方法 选择1991年～2010年本院收治的烧伤面积≥50％烧伤总面积(TBSA)94例患者临床资料.根据入院时间顺序,分为前10年(1991年～1999年,A组)和后10年(2000年-2010年,B组)2组,比较两组休克期补液总量及晶体、胶体和水分各成份补液量,尿量,以及伤后10d内脏器并发症发生率和死亡率.结果 B组患者伤后第1个24 h晶体、胶体、水分补液量、补液总量、尿量及伤后第2个24 h晶体补液量、补液总量、尿量均较A组患者显著增多.B组患者伤后10d内脏器并发症发生率和死亡率分别为7.69％及2.56％,较A组(27.3％,18.18％)均显著降低(P＜0.05).结论 对于地处广州地区大面积烧伤患者,休克期补液治疗需结合地区气候特点,强调个体化补液方案,适当增加烧伤休克期内胶体、晶体和水分补液量和比例,以降低内脏器并发症发生率和死亡率.
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