The effect of extensive excision of burn wound with invasive infection on hypermetabolism in burn patients with sepsis
柴家科
盛志勇
刁力
Yang Hongming
Gao Jianchuan
Xu Minghuo
1.Clinical Department of Burn Institute, 304th Hospital, Beijing 1000372.Clinical Department of Burn Institute, 304th Hospital, Beijing 1000373.Clinical Department of Burn Institute, 304th Hospital, Beijing 1000374.Clinical Department of Burn Institute, 304th Hospital, Beijing 1000375.Clinical Department of Burn Institute, 304th Hospital, Beijing 1000376.Clinical Department of Burn Institute, 304th Hospital, Beijing 100037
摘要：Objective: To evaluate the effect of extensive excision of invasive burn wound infection on hypermetabolic response in burn patients with sepsis. Methods:Eight patients with major burn, complicated by invasive burn wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. REEs were monitored by means of Cardiorespiratory Diagnostic System (Medical Graphics Corporation, USA) at patients bedside. Plasma concentration of IL-6、IL-8、TNF-α and LPS were assayed before and after surgical intervention and at the time when the patients' vital signs became stable. Correlation analysis between REEs and IL-6、IL-8、TNF-α、LPS was respectively made. Results: A total of 8 patients were treated and all of them survived. Values of REE before surgical intervention were significantly higher than those after surgical intervention(P＜0.01), and when patients vital signs became stable the values were significantly lower compared with that after surgical intervention(P＜0.01). The plasma concentrations of IL-6、 IL-8、TNF-α and LPS after excision of invasive burn wound infection were significantly lower than those before surgical intervention (P＜0.05). The lowest levels of these inflammatory mediators were observed when the conditions of patients became stable, and the values were significantly lower compared with those before surgical intervention (P＜0. 001). There was a significant positive correlation between REE level and respective values of plasma IL-6、 IL-8、 TNF-α、 LPS(P ＜0.01). Conclusions: It is deemed that the extensive excision of invasively infected burn wound in patients with major burn should be performed as early as possible to reduce an increased release of inflammatory mediators, and to control the hypermetabolic response during sepsis.
机标关键词：surgical interventionwound infectioninflammatory mediatorsDiagnostic System
资助基金：国家自然科学基金(39970716)the grant from the Research Foundation of Medicine and Hygiene(98M155)
论文发表日期：2000-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：4( 3-6 )
英文信息