损伤控制外科策略在救治严重电烧伤中的应用  

Application of damage control surgery in treatment of severe electric burn

作　　者：郭志谦[1] 雷磊[1] 李金虎[1] 高优[1] 孙肇晟[1] 许建允 陈旭林[2] 

机构地区：[1]厦门大学附属成功医院暨解放军第174医院烧伤整形科,福建省厦门市361003 [2]安徽医科大学第一附属医院烧伤科,合肥市230022

出　　处：《实用医学杂志》2016年第10期1619-1622,共4页The Journal of Practical Medicine

摘　　要：目的：探讨损伤控制外科（DCS）策略在严重电烧伤救治中的应用效果。方法：回顾性分析45例严重电烧伤患者临床资料,按是否实施损伤控制性手术原则分为两组。DCS组对电弧烧伤的深Ⅱ度创面一期磨削痂、移植脱细胞异种真皮基质,Ⅲ~Ⅳ度电接触烧伤创切痂后留置VSD敷料,二期再行植皮或皮瓣修复。一期手术组则急诊行清创、切削痂、植皮或皮瓣封闭创面。比较两组在平均手术时间、住院时间、致残率、死亡率、并发症等方面的差异。结果：DCS组手术时间、致残率及并发症发生率均较一期手术组明显降低,住院时间和死亡率无差异。结论：应用DCS策略可降低严重电烧伤患者并发症、优化治疗效果。Objective To explore the effect of damage control surgery（DCS） in the treatment of severe electric burn. Methods Retrospective analysis on clinical data of 45 patients with severe electric burn was conducted. According to implementing DCS or not, patients were separated into DCS group and control group. In DCS group, tangential excision and transplanted xenogenic acellular dermal matrix was conducted for severe electric burn cases with deep Ⅱ degree wound, and escharectomy and VSD dressing for Ⅲ ~ Ⅳ degree electric contact burn wound at the first stage then skin-grafting or skin flap-grafting on the secong stage was applied. For control group,debridement, tangential excision or escharectomy and skin-grafting or skin flap-grafting to close the wound were conducted. We compared the difference in terms of operation time, length of stay, disability rate, mortality and complications between 2 groups. Results The operation time, incidince of disability and complications in DCS Group obviously decreased but there was no difference in length of stay and mortality in both groups. Conclusion DCS is effective for reducing complications and optimizing therapeutic effect for severe electric burn patients.

关 键 词：电烧伤 损伤控制 外科手术 VSD敷料 脱细胞异种真皮 

分 类 号：R647[医药卫生—外科学]