“改善大面积烧伤早期处理方案”对其愈后的影响研究  

The Effects of Improved Early Treatment Measures on Outcome of Severely Burned Patients

作　　者：梁志刚[1] 梁达荣[1] 李孝健[1] 霍丽贞[1] 邓忠远[1] 

机构地区：[1]广州市红十字会医院烧伤科,广州510220

出　　处：《现代临床医学生物工程学杂志》2003年第3期203-204,共2页Journal of Modern Clinical Medical Bioengineering

摘　　要：目的　分析改善烧伤早期处理对大面积烧伤患者愈后的作用 .方法　总结自 1996年 1月～ 2 0 0 2年 12月大面积烧伤 (烧伤面积均大于 30 % ) 4 2 6例 ,以 2 0 0 0年 1月 1日为界分 2组 ,界前为A组 ,界后为B组 .B组同时应用了经改善的早期治疗新措施 :改良的、更充分的液体复苏 ;山莨菪碱恢复肠道血供 ;尽早的肠内营养 ;更果断的气道支持 ;悬浮床广泛的早期应用保护创面 ;氧自由基清除剂防止氧自由基的损害 ;生长激素早期应用 ,减轻炎症介质失控的损害 ;早期 (或休克期 )大面积切痂植皮 ;有活力的异体皮广泛应用于覆盖创面 ;微粒植皮及网状植皮被作为主要植皮手段等 .结果　A组 311例 ,病死率 16 1% (死亡 5 0例 ) ,B组 115例 ,病死率 7.8% (死亡 9例 ) (p <0 .0 1) ,A组平均治愈时间 86± 3天 ,B组平均治愈时间 4 5± 2天 (p <0 .0 1) .结论　改善了的烧伤早期处理措施 ,可以显著减少病死率 ;Ojective To determine if the improved early treatment measures developed from domestic and international and our surgical research results have any effects on mortality rate and outcome in severely burned patients. Methods 426 extensively burned patients (burn Size exceeding 30%TBSA) amitted to the clinical department from January 1996 through December 2002 were studied , The mortality rate and outcome were compared in patient groups hospitalized before and after 2000 when improved early treatment measures began to be extensively executed .These measures consisted of improved more adequater fluid resuscitation ,restoration of bowel blood supply with anisodamine (654-2),immediately tube feeding after hospitalized, more resolute respiratory tube support ,extensively bed in the air used ,use of oxygen free radical scavengers (e .g .mennitol, vitaminC ), early use of rhGH ,extensive escharectomy during early or shock stage,vital heterobody skin extensively used to cover wounds ,microskin and netskin grafting served as main measure of graft ,etc. Results Before 2000 when very few improved early treatmrent measures were applied ,the mortality rate was 16.1% (50 out of 311 ), average recovery period was 86±3 days ,After 2000 ,with the extensive various application of early treatment measures ,the mortality rate,7.8% (9 out 115),average recovery period ,45±2 days. Conclusions Our results suggest that above-mentioned various treatment measures may reduce mortality and shorten period of hospitalization.

关 键 词：烧伤 早期处理 愈后 治疗 生长激素 液体复苏 

分 类 号：R644[医药卫生—外科学]