瓦斯爆炸深Ⅱ度烧伤创面早期削痂时机选择  

Clinical observation of the effect of tangential excision within 24 postburn hours on the patients with deep partial thickness burn induced by gas explosion

作　　者：呼兵[1] 任文杰[1] 孟伟正[1] 刘林洪[1] 王明君[1] 李嵩岳[1] 陈明国[1] 周一平[2] 杨雅秋[1] 

机构地区：[1]河南省平顶山煤业集团总医院,473000 [2]南方医科大学

出　　处：《中国实用医刊》2009年第21期4-6,共3页Chinese Journal of Practical Medicine

基　　金：河南平顶山煤业（集团）有限责任公司科技开发项目（41040220061116）

摘　　要：目的探讨瓦斯爆炸深Ⅱ度烧伤患者伤后24h内创面行削痂术的安全性和临床疗效。方法154例有削痂手术指征并在伤后24h内行削痂术的深Ⅱ度烧伤患者为A组；107例削痂条件相似并按常规在伤后72h行削痂术的深Ⅱ度烧伤患者为B组；57例削痂条件相似并按常规在伤后168h行削痂术的深Ⅱ度烧伤患者为C组，比较三组休克期补液量、休克征象发生率、回吸收期的生命体征、尿量及愈合时间。结果三组患者在休克期补液量、休克征象发生率方面差异均无统计学意义（P〉0．05）；A组休克期尿量明显增多，回吸收期的体温、心率与B、C组明显不同（P〈0．05或P〈0．01）；A组创面平均愈合时间较B、C组短（P〈0．01）。结论深Ⅱ度烧伤创面于伤后24h内削痂是安全的，并能缩短创面愈合时间。Objective To investigate the safety and clinical effect of the tangential excision of the patients with deep partial thickness burn induced by gas explosion within 24 postburn hours （PBHs）. Methods One hundred and fifty -four patients with deep partial thickness burn with the indication for tangential excision, the operation was carried out within 24 PBHs. These patients were designated as group A. Another group of 107 patients with similar conditions undergoing tangential excision during 72 PBHs were designated as group B and the other group of 57 patients with similar conditions during 168 PBHs were designated as group C. The amount of fluid infusion during shock stage, the shock signs,the vitalsigns during recovery period,the urine output,as well as the healing time were compared between the three groups. Results There was no obvious difference in the amount of fluid infusion and the shock signs between the three groups. There were evident difference in the body temperature and heart rate during recovery period, with the urine output increased dramatically during shock stage in group A when compared with those in group B and group C （ P 〈 0.05 or P 〈 0.01 ）. The average wound healing days in group A were less than that in group B and group C（ P 〈 0.01 ）. Conclusions Tangential excision within 24 PBHs are applicable and safe for the patients with deep partial thickness burn, and wound healing time is thus shortened.

关 键 词：瓦斯爆炸 烧伤 削痂 创面愈合 休克 

分 类 号：R644[医药卫生—外科学] R730.26[医药卫生—临床医学]