May S R, DeClement F A
Burns Incl Therm Inj. 1983 Mar;9(4):257-66. doi: 10.1016/0305-4179(83)90055-4.
Sixteen patients with body surface area (BSA) burns of 4 per cent to 83 per cent, with whom single hypnotherapeutic interventions were attempted 5.3 +/- 3.4 h post burn, were compared to 16 matched controls. Ten physiological parameters related to fluid volume and haemodynamics were recorded on the first two post burn days. The only significant difference discovered was elevated urine output 0-48 h postburn in successfully hypnotized patients (P = 0.01). This difference was inversely related (r = -0.94, P = 0.009) to burn size from a 10 per cent BSA burn (3.9 litres/48 h) to a 35 per cent BSA burn (1.6 litres/48 h). A statistically suggestive (P = 0.13) increase in urine output occurred in patients in whom hypnotic trance induction was unsuccessfully attempted. Patients with BSA burn sizes greater than or equal to 50 per cent, who presented with significant physiological stress and hypovolemia, were found not to be susceptible to hypnotic trance induction, and derived no physiological benefit. Attempted hypnotherapeutic intervention per se, with its psychotherapeutic component, may act only to reduce affective or psychological stress and anxiety. This psychological stress reduction apparently facilitates the loss of retained fluid in patients with small burns by a mechanism which is overwhelmed by the physiological stress of a major burn injury.
16例烧伤体表面积（BSA）为4%至83%的患者，在烧伤后5.3±3.4小时接受了单次催眠治疗干预，并与16例匹配的对照组进行比较。在烧伤后的头两天记录了与液体容量和血流动力学相关的10项生理参数。发现的唯一显著差异是成功接受催眠的患者在烧伤后0至48小时尿量增加（P = 0.01）。这种差异与烧伤面积呈负相关（r = -0.94，P = 0.009），从10% BSA烧伤（48小时内3.9升）到35% BSA烧伤（48小时内1.6升）。在尝试诱导催眠恍惚未成功的患者中，尿量有统计学意义的增加趋势（P = 0.13）。发现烧伤体表面积大于或等于50%、存在明显生理应激和血容量不足的患者不易被诱导进入催眠恍惚状态，也未获得生理益处。单纯的催眠治疗干预及其心理治疗成分，可能仅起到减轻情感或心理应激和焦虑的作用。这种心理应激的减轻显然有助于小面积烧伤患者排出潴留液体，而大面积烧伤损伤的生理应激会掩盖这一机制。
