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目的探讨重度烧伤患者心率增快的原因及其处理对策。方法回顾性的总结了近十年来我科的TBSA>30%以上的225例烧伤患者住院期间的心率增快的原因及其处理方法。结果 225例TBSA>30%的烧伤患者心率均增快,其中休克期心率增快者186例,感染期以后心率增快者169例,162例有高代谢期引起心率增快,全部患者均有由于体温增高引起心率增快,12例小儿患者麻醉时应用氯胺酮引起心率增快,25例由于手术时输入大量少白红细胞时晶体输入不够引起心率增快。发生原因为休克、感染、全身脓毒血症、输液过快过多、肺部感染、肺水肿、体温增高、代谢增加、心功能不全、应用氯胺酮针,晶胶体输入顺序不对等。结论去除病因、休息、减轻心脏负荷,早期胃肠道营养、抗感染、扶持心肌收缩力、解除心脏压迫、应用利尿剂、避免过多输液、改善心肌缺血、纠正心率失常,补液时先晶后胶,输入胶体与晶体比例以1:2为宜等治疗可以有效降低过快的心率,使血流动力学正常恢复。
Objective To investigate the causes of heart rate increase in patients with severe burn and its treatment. Methods A retrospective review was made on the causes of heart rate increase and its treatment in 225 burn patients with TBSA> 30% in our department during the past 10 years. Results The 225 patients with TBSA> 30% had faster heart rate, 186 patients with accelerated heart rate in shock stage, 169 patients with accelerated heart rate after infection stage, 162 patients with high metabolic rate, and all patients had Due to increased body temperature caused by rapid heart rate, 12 cases of pediatric patients with ketamine anesthesia caused by heart rate increased, 25 cases due to surgery, a large number of white red blood cells into the lack of crystal input caused by rapid heart rate. Occurrence of shock, infection, systemic sepsis, infusion too fast, pulmonary infection, pulmonary edema, increased body temperature, increased metabolism, cardiac insufficiency, the application of ketamine needle, crystalline gel input sequence is not equal. Conclusion The removal of etiology, rest, reduce the heart load, early gastrointestinal nutrition, anti-infective, support myocardial contractility, relieve cardiac pressure, the application of diuretics, to avoid excessive infusion, improve myocardial ischemia, correct heart rate disorders, After the plastic, enter the colloidal and crystal ratio to 1: 2 is suitable for treatment can be effective in reducing excessive heart rate, hemodynamic normal recovery.