47例严重电烧伤的围手术期处理  

Perioperational Period Management of 47 Cases of Severe Electric Burn

作　　者：齐顺贞[1] 刘建春[1] 孙志刚[1] 林洪武 朱玉风 于清新[1] 陶白江 范国庆 

机构地区：[1]白求恩国际和平医院烧伤科

出　　处：《中国烧伤创疡杂志》1995年第3期30-31,33,共3页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：本文通过对1973～1991年收治47例严重电接触伤的研究，提示围手术期处理的好坏，对病人安危和功能快复至关重要。一．术前处理，1．电接触烧伤术前应常规查心电图，异常者尽可能使其恢复正常，或应用药物支持，以免术中发生意外。2．电烧伤早期复苏补液量远高于同等面积热烧伤，本组对13例不同程度休克者，第一个24小时补液总量按Ⅱ°、Ⅲ°烧伤面积（％）×体重（kg）×5～7ml计算。3．筋膜减压切开越早越好，一方面可以减压，另一方面可观察骨邻近深层肌肉组织的活力，最大限度地保留肢体长度。二．术中术后处理，1．手术前后均应防治继发性出血，提出5条继发性出血的防治措施。2对截肢需采取慎重态度，标准是除肢体全部坏死，各种组织损坏而无法修复和严重感染有威胁生命者应尽早截肢外，尽可能保留肢体恢复其功能。肢体残端长度短于标准者，通过提高移肢技术而解决。(Dept. of Burns, International Peace Hospital Named After Dr. Norman Bethune)From 1973 to 1991, 47 cases of severe electricburn were treated in the hospital. Perioperationalmanagement was very important which included:A. Before operation: 1. Electrocardiographic ex-amination. Those who had abnormal electrocar-diogram had to be treated to avoid accident during op-eration. 2. Resuscitation infusion should be performedearly and the infusion volume shouId be more than thatfor thermal injury of the same area. 13 patients withshock had fluid infusions. The total amount of fluid in-fused in the first 24 hours was caIculated according tothe formula: Burn area (%) x body weight (kg) x 5 to7 ml- 3. Decompression fasciotomy should be per-formed as early as possible. On one hand, pressure couId be reduced, and on the other hand, obServation of the vitality of deep layer muscular tissue could be made to preserve the length of the extremities to the greatest extent.B. During and after operation: 1. Prevention of secondary hemorrhage and suggestion of preventivemeasures. 2. Before amputation, careful considera-tion and precaution should be taken. Those who had whole limb necrosis and unrepairable damage of the tissues and severe infections which were life-threat-ening should be subjected to amputation as early as possible. Those who did not have life-threatening or unrepairable damage should not be subjected to am-putation. Measures should be taken to preserve the limb and to promote recovery of the function. if the stump was short,transplantation of limb could be per-formed

关 键 词：烧伤 电烧伤 围手术期 处理 

分 类 号：R647.05[医药卫生—外科学]