The Clinical Analysis Of Common Critical Values Of The Burn Ward In A Hospital In Nanning

Objective Count First Affiliated Hospital of Guangxi Medicalburn ward common critical value, analyse related causes, provide areference for clinical diagnosis, treatment and prevention of criticalillness.Methods Use a retrospective survey methods：collect criticalvalue reporting results of First Affiliated Hospital of Guangxi MedicalUniversity2012-2013burn unit, and the critical value of the patient’s sexcollection appeared, age, cause of injury, burn size, length of stay, etc.,and then analyse appeared high ratio critical values.Results There are392cases of critical values, the top of the most is wound bacterial culture(36.4%), followed by white blood cell count (19.2%), serum potassium(12.6%), creatine kinase isoenzyme CKMB (6.67%), glucose (6.07%),platelet count (5.6%), blood in general bacterial culture (3.33%), arterialblood gas analysis (2.82%).1.In the wound culture results, there are142cases of multi-drugresistant Bacterias, including44cases of Staphylococcus aureus,79cases of Acinetobacter baumannii, and18cases of Pseudomonasaeruginosa. Critically ill patients (severe and severe burn) accounted for 67.6%of specimens. First appearance time was12±7days.2.White blood cell count of75cases of critical values, in whichfluctuations between30~60.27×109/L, patients age at332days ofage to82years old. In the38adult patients(>18years),35cases wereburnt cases(injured area at26%~98%TBSA),5cases were got afteroperation, seven cases within24hours after the injury, and23cases ofwhite blood cell count gradually increased to a critical value. Theremaining37cases the age of332days to5years,34cases of burnpatients (injured area of15%~67%TBSA),3cases of urgent,22caseswithin24hours after operation, and nine cases of white blood cells countgradually increased to a critical value.3.Serum potassium values were reported in49cases of criticalfluctuations, of which36cases <2.8mmol/L,13cases higher than6.2mmol/L. Thelowest is1.93mmol/L， and the highest is8.08mmol/L.After giving clinical treatment, can be controlled to a valueoutside the critical range.4.The symptoms of Potassium disorders in burn ward is hidden，it isnecessary to review it regularly.5.16cases of Platelet counts critical value range3.5~40×109/L,in addition to two cases of patients with scar review properly. The rest aresevere burn patients, in which12cases occurred sepsis duringhospitalization,8cases were cured,6cases died. 6.There are22cases of glucose critical value, including one caseless than2.2mmol/L, while21cases higher than22mmol/L. In additionto three cases of diabetes, the remaining18cases were severe burnpatients.4cases died in7-15days after burn.7.26cases of Creatine kinase (CK-MB) were reported in thecritical values, the critical values are high values, ranging of115~284U/L. Test specimens were surgent, including21cases of electrical injurypatients,5cases of severe burn patients. The values of electrical injurypatients gradually recovered; five cases of severe burn patients withburns covering the range of72~95%TBSA, were associated withhypovolemic shock at admission. The results of the third day was nosignificantly decline.4cases died in2-12days, one case discharged after3days.Conclusion Through a comprehensive analysis of the reasons for theburn ward critical value, we use good predictability of treatment, toprotect patient safety early.1.Multi-drug resistant bactirias takes up the highest proportion ofburns ward (36.4%).2.In burn ward WBC critical value come up for three reasons: ablood concentration, these critical values often seen in children withsevere burn patients ater urgent detection;3.burn infections are often incritically ill patients with relatively large adult male;3Surgical stress, multi appearing after review, was transient.3. Hyperglycemia in severe burns primarily due to early stressresponse at the beginning, while in the late hyperglycemia appearsbecausse of pathogenesis of pancreatic secretory dysfunction caused bythe structure and the relative lack of insulin secretion and insulinresistance.4.The sooner thrombocytopenia occurs, the faster the decline, themore severe the disease are.5.Creatine kinase (CK-MB) were seen in electrical injury patientsmost, followed in severe burn patients.