烧伤后全身性感染防治的临床研究  

Clinical Study on the Prevention and Treatment of Systemic Infection in Burn Patients

作　　者：吴祖煌 刘敏 夏照帆[2] 刘世康[2] 

机构地区：[1]解放军第九五医院烧伤整形科,福建莆田351100 [2]第二军医大学附属长海医院烧伤中心

出　　处：《中国医师杂志》2005年第3期301-303,共3页Journal of Chinese Physician

基　　金：全军医学科学技术研究"十五"指令性课题 (0 1L0 55)

摘　　要：目的　总结并提出烧伤后全身性感染的防治措施。方法　将本科 1990 -0 1～ 2 0 0 3 -12收治的 44 3 0例烧伤病人中 3 0 9例发生全身性感染的病例 ,分成二个治疗阶段 ,结合临床一些新的治疗方法的使用 ,分析烧伤后全身性感染的发生率及死亡率降低的主要原因。结果　第 2阶段全身性感染的发生率 (5 68% )和死亡率 (0 3 0 % )均显著低于第 1阶段 (P <0 0 1)。治愈率和不同烧伤面积治愈率均逐步提高。结论　早期、有效、充分的液体复苏 ;深度烧伤创面及早切 (削 )痂植皮 ;加强内脏器官的保护与支持 ;早期肠道喂养 ;有效抗生素的短程使用等是降低全身性感染发生率、提高治愈率的最重要措施。一旦发生烧伤创面脓毒症 ,尽早去除坏死组织是成功救治全身性感染的关键所在。Objective To sum up the experiences in the prevention and treatment of systemic infection after burn injury. Methods 309 burn patients with systemic infection treated in our department from January 1990 to December 2003 were enrolled in this study. The patients were divided into two groups according to their hospitalized time: group 1(from 1990 to 1996) and group 2(from 1997 to 2003). The incidence and mortality of systemic infection were compared between the two groups, and the efficacy of different treatment strategies was analyzed. Results The morbidity of postburn systemic infection in the patients was 6.98%(309/4430). The incidence and mortality of systemic infection were 5.68% and 0.30% in the group 2, respectively, which were significantly lower than those in the group 1. Conclusion Rapid and adequate fluid resuscitation for burnshock, effective control of wound infection, early excision of crust and skin grafting for deep burnwounds, and reinforcement of organ support were key factors to decrease the incidence of systemic infection and increase the curative frequency. Once burn wound sepsis occurred, prompt removal of infectious necrotic tissues was a key means to ensure a good clinical outcome.

关 键 词：全身性感染 烧伤 发生率 死亡率 临床研究 治愈率 人中 本科 结论 支持 

分 类 号：R644[医药卫生—外科学] R631[医药卫生—临床医学]