早期综合治疗在重度烧伤中的应用  

Clinical application of early synthesized treatment in extensively burned patients

作　　者：胡德林[1] 方林森[1] 余又新[1] 王春华[1] 徐庆连[1] 

机构地区：[1]安徽医科大学第一附属医院烧伤科,合肥230022

出　　处：《安徽医学》2012年第11期1433-1435,共3页Anhui Medical Journal

基　　金：安徽省卫生厅科研基金项目(项目编号:2009A067)

摘　　要：目的探讨早期综合治疗在重度烧伤临床治疗中的应用效果。方法选择2009年1月至2012年8月收治的重度烧伤患者(烧伤面积≥70%TBSA、Ⅲ度烧伤面积≥30%)20例作为治疗组,应用早期有效充分液体复苏、经肠道营养和早期大面积切削痂有效覆盖创面的综合治疗方案;2009年前住院应用传统治疗方法治疗的重度烧伤患者20例作为对照组。观察2组患者第1次手术创面修复情况和手术次数、第1次手术前后TPR和ALB变化、创面愈合及住院时间。结果治疗组第1次手术植皮覆盖创面百分比高于对照组,手术次数减少,差异有统计学意义(P<0.05)。治疗组术后血浆总蛋白(TPR)、清蛋白(ALB)下降,但与术前相比差异无统计学意义(P>0.05);而对照组TPR、ALB术后明显下降,分别与手术前及治疗组术后相比差异有有统计学意义(P<0.05)。除去死亡患者,治疗组创面愈合时间和住院时间均少于对照组,差异有统计学意义(P<0.05)。结论早期综合治疗是重度烧伤患者早期合理、有效的治疗措施,能缩短重度烧伤患者的创面愈合时间和住院时间。Objective To evaluate the clinical effect of early synthesized treatment in extensively burned patients.Methods Twenty extensively burned patients（body＇s area burned exceeding 70%TBSA and Ⅲ degree area burned exceeding 30%TBSA） were regarded as treated group in our department from January 2009 to August 2012.Patients were applied the early synthesized treatment in treated group.The treatment measures consisted of rapid and adequate fluid resuscitation,early tube feeding and effectively covered wound after extensive eschar excision in one operation.Twenty extensively burned patients（body＇s area burned exceeding 70%TBSA and Ⅲ degree area burned exceeding 30%TBSA） were regarded as control group in our department before 2009.Patients undertook the traditional treatment in control group.The clinical effects of patients were observed in two groups.Results ①The percentage of wound covered in treated group was higher than those in control group;the operation frequency decreased;the difference has statistic sigificance between the two groups（P〈0.05）.②TPR and ALB levels after operation in treated group were not significantly lower than those before operation（P〉0.05）,but they were significantly lower in control group than those before operation and after operation in treated group（P〈0.05）.③The wound healing time was cut short and hospitalization time was shortened in treated group,and the difference was statistically significant when the died cases excluded（P〈0.05）.Conclusion The early synthesized treatment is feasible and effective for extensively burned patients,which can shorten the time of the wound healing and hospitalization.

关 键 词：重度烧伤 早期综合治疗 手术次数 TPR ALB 住院时间 

分 类 号：R644[医药卫生—外科学]