特重度烧伤合并消化道大出血的救治  

Treatment of severe burn combined with massive hemorrhage

作　　者：王硕 杨丙厚 李翔 孙羽飞 曹书广 祝天华 徐闽军 李雪银 李天宇 赵俊祥 WANG Shuo;YANG Binghou;LI Xiang;SUN Yufei;CAO Shuguang;ZHU Tianhua;XU Minjun;LI Xueyin;LI Tianyu;ZHAO Junxiang(Burns and Plastic Surgery Department, The Affiliated Nanshi Hospital of Henan University, Nanyang 473065, China)

机构地区：[1]河南大学附属南石医院烧伤整形科

出　　处：《河南大学学报（医学版）》2019年第3期177-178,共2页Journal of Henan University:Medical Science

摘　　要：〔目的〕分析特重度烧伤后消化道大出血患者的临床疗效。〔方法〕消化道出血首选内科保守治疗,当保守治疗后伴有出血性休克;12 h输血2 000 mL以上,小儿300 mL以上,血色素不升反降;治疗48 h后仍出现进行性柏油样血便,应考虑急诊胃大部切除手术治疗。〔结果〕12例痊愈,1例死于创面真菌性感染合并多器官功能衰竭,1例死于胃癌后期恶病质。〔结论〕植皮封闭创面缩短病程可避免许多并发症发生。〔Objective〕To analyze the clinical efficacy of patients with severe gastrointestinal hemorrhage after severe burns.〔Methods〕Gastrointestinal hemorrhage is the first choice for conservative treatment of internal medicine. When conservative treatment is followed by hemorrhagic shock;12 hours of blood transfusion is more than 2 000 mL, children are more than 300 mL, hemoglobin does not rise and fall;after 48 hours of treatment, progressive tar-like bloody stools should still appear. Consider emergency surgery for major gastrectomy.〔Results〕12 cases were cured, 1 case died of fungal infection of the wound combined with multiple organ failure, and 1 case died of cachexia in the late stage of gastric cancer.〔Conclusion〕Skin graft closure of the wound shortens the course of the disease and avoids many complications.

关 键 词：特重度烧伤 消化道大出血 救治 

分 类 号：R932[医药卫生—生药学]