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Лечение ожогового шока
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Лечение ожогового шока

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by admin26.07.2015
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При ожоговом шоке возникает целый ряд взаимосвязанных патофизиологических и биохимических нарушений, которые не могут быть сведены к преимущественному воздействию какого-либо одного даже весьма важного фактора: гиповолемии, утере части кожного покрова, нарушению проницаемости капилляров, интоксикации, расстройству микроциркуляции и т. д. Несмотря на всю значимость этих явлений, ожоговый шок необходимо рассматривать с позиций целостности организма и его взаимоотношений с внешней средой. Такая точка зрения предполагает комплексный метод лечения больных с ожоговым шоком, в основе которого лежат:

1) борьба с афферентной им пульсацией (обеспечение психоэмоционального покоя, введение нейролептиков, использование окси бутирата натрия, анальгетического наркоза, отказ от первичного туалета ран);

2) оксигенотерапия;

3. возмещение ОЦК и удержание ее в сосудистом русле;

4. профилактика и лечение нарушений водно-солевого обмена и выделительной функции почек; 5) борьба с метаболическим ацидозом, 6) коррекция нарушений энергетического обмена; 7) применение фармакологических средств — обезболивающих, сердечных, средств, нормализующих функцию ЦНС, спазмолитиков, витаминов, гормонов и антибиотиков.

Из общих мероприятий при лечении ожогового шока рекомендуется согревание больного. Если нет рвоты, необходимо давать пить горячий сладкий чай или кофе, щелочные минеральные воды или простой соляно-щелочной раствор (1-2 г питьевой соды и 3-4 г поваренной соли на 1 л воды). Для интенсивной терапии всем больным в состоянии ожогового шока выполняют «правило трех катетеров».

Один катетер вводят в нос для инсуффляции кислорода, второй — в мочевой пузырь для контроля диуреза, третий катетер вводят в вену (желательно центральную) для проведения инфузионной терапии.

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