摘要
目的总结三度烧伤≥90%病人抢救经验。方法选择1966年～2002年烧伤三度面积≥90%的病例,主要采取以及时正确的补液为主的综合方法复苏;中重度吸入性损伤伤员早期行气管切开术,保持气道通畅;积极扶植机体,正确处理创面,合理使用抗生素和必要的消毒隔离制度,防治烧伤感染和脏器并发症;三度创面处理的原则:尽早地清除坏死组织,及时、切实地封闭创面,自体皮和异体(种)皮结合,异体皮开窗嵌皮法和微粒、皮浆移植大张异体(种)皮覆盖术,以及肠内营养摄入和功能恢复治疗。结果48例病人16例救治成功,7例可以生活自理。结论及时正确的复苏是抢救的基础,切实有效的封闭创面是抢救成功的关键。防治感染与脏器并发症贯穿治疗的全过程。
Objective To summarize the experiences in the treatment of severely burned patients with third degree burn area over 90% TBSA. Methods Forty-eight patients with third degree burn area over 90%TBSA during 1966 to 2002 were enrolled in this study. The primary treatment included immediate and optimal fluid resuscitation. Early tracheotomy was applied to those patients with moderate or severe inhalation injury, so as to keep smooth airway. To support the systematic defense power and to deal with the wounds correctly. Antibiotics were employed reasonably. Disinfection and isolation rules were obeyed strictly. Burn infection and internal organ complications were prevented and treated. The principle of the management of third degree burn wounds ： debridement of necrotic tissue as early as possible and coverage of the burn wound in time and completely. The coverage of the burn wound could be accomplished by the intermingled grafting of autoskin and alloskin, by that small pieces of autoskin were inlayed in the open holes in the large sheet of alloskin and by microskin grafting, by skin plasma grafting with large sheet alloskin coverage. In addition,enteral nutrition support and physical therapy were also adopted. Results Sixteen patients out of the 48 were rescued with 7 of them minding their own life. Conclusions Correct and in time fluid resuscitation were the basis of rescuing. Faithful wound coverage was key point of the rescuing. Infection control and internal organ complication management were carried out throughout the whole process.
出处
《中华损伤与修复杂志（电子版）》
CAS
2007年第2期98-103,共6页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
关键词
休克
切痂
削痂
植皮
气管切开术
微粒皮移植
皮浆移植
大张异体皮开窗嵌入
Shock, Escharectomy, Tangential excision, Tracheotomy, Microskin grafting, Skin plasma grafting, small pieces of autoskin inlayed in the open holes in the large sheet of alloskin
