大面积烧伤患者休克期切痂冷冻异体皮植皮的临床疗效  

Use of cryopreserved allograft in extensive wound excision and closure of the major burned patients in their shock stage——A clinical investigation

作　　者：贾晓明[1] 柴家科[1] 郭振荣[1] 朱兆明[1] 高维谊[1] 杨红明[1] 高建川[1] 李利根[1] 许明火[1] 孔秋华[1] 张秉武[2] 

机构地区：[1]解放军304医院烧伤研究所临床部,北京100037 [2]解放军304医院烧伤科

出　　处：《军医进修学院学报》1999年第3期177-181,共5页Academic Journal of Pla Postgraduate Medical School

基　　金：军队留学回国人员医学科研启动基金!项目 ;批准号 97H3

摘　　要：目的:大面积深度烧伤创面和焦痂的存在造成了机体体液大量的丢失,而且也是多种有害介质释放及导致全身侵袭性感染的滋生地。在临床上,亦可引发机体超高代谢,以及多种器官功能衰竭及并发症的发生。方法:临床上尽早地切除焦痂,利用冷冻储存活力良好的异体皮覆盖创面已成为当今烧伤治疗领域中所借鉴的成功经验。结果:本文分析总结我科1991年2月至1998年5月的63例大面积烧伤休克期切痂冷冻异体皮移植的临床效果的观察。结论:1大面积烧伤患者休克期切痂自体微粒+大张异体皮移植是提高成活率、减少感染及并发症的重要措施。2活力良好的异体皮是休克期切痂创面覆盖的有力保证。3通过本组的大面积烧伤患者休克期切痂异体皮移植后临床效果的判定,分析出我们在临床上应抓紧术中创面切痂要彻底,止血操作要完善,储存的异体皮活力要高,缝合固定要牢靠,敷料包扎要适宜等几个处理要点。Objective:The wound and eschar not only lead to the loss of large amount of body fluid but also play pivotal roles in the production of various toxins and inflammatory mediators. It is one of the most important stimulator of postburn hypermetabolism and MSOF. Methods:Experiences have been accumulated clinically in recent years which showed that it was both safe and beneficial for the burned wound to be excised and covered with cryopreserved allograft as soon as possible. Results:63 cases of major burns are summed up in which the extensive burned wound excision in the acute shock stage and the coverage of excised burn wound with cryopreserved allograft skin were performed in this article. Conclusion:(1) The survival of major burn patients can be increased by extensive wound excision and the coverage of excised wound with autologous microskin and large sheet of allograft skin. (2) the allograft skin with high viability can ensure the performance of extensive wound excision. (3) with the summary of clinical effects of our data, several essential treatments in the excision are recommended: excising eschar and wound entirely, utilizing cryopreserved allograft skin with high viability, stanching bleeding perfectly, suturing and fixing firmly, binding up dressing suitably.

关 键 词：烧伤 休克期 切痂 冷冻异体皮 皮肤移植 

分 类 号：R644.05[医药卫生—外科学] R622.1[医药卫生—临床医学]