MEBO治疗小儿烧伤451例报告

451 CASES OF PEDIATRIC BURN TREATED WITH MEBO

作者对451例不同程度烧伤小儿运用MEBO治疗的同时,注意休克、败血症防治及创面的处理,通过四年的临床实践,认为传统疗法较为复杂,消毒不注意可造成组织的坏死引起败血症。而MEBO疗法具有良好的通透性,对创面具有明显的保护湿润作用,止痛效果好,能够保持创面生理需要的湿润环境,保障创面组织有效药物恒定浓度供给,对控制烧伤感染,防止败血症的发生起着决定性的作用,作者在涂MEBO同时测出创面pH值以便用药。本文还提出了对有可能发生休克的患儿应早期正规抗休克治疗,密切注意尿量的变化,以便调节输入的速度。对婴幼儿烧伤面积75％以上者必须警惕休克发生,总结出第二个24小时胶体与电解质溶量补入为第一个24小时一半,水分同第一个24小时一样。补液原则:三先、三后、二早、一防能够很好防治烧伤儿休克,作者认为MEBO疗法简单,同时若没有休克、败血症发生,创面处理得当,则能取得满意疗效。

451 burnt children were treated with MEBO. Attention was paid to prevention and treatment of shock and septicemia and the management of the wounds. After practising for 4 years, the authors recognized that conventional treatment was rather complicated. If not thoroughly sterilized, the necrotic wound tissue would cause septicemia. MEBO has good permeability. It protects and moisturizes the wounds and has good analgesic effect. It creates moist environment physiologically suitable for wound healing and keeps an adequate concentration of the ointment in the wounds. Thus it effectively controls the infection and septicemia. pH value of the wounds was determined before application of MEBO. Early anti-shock measures should be taken to prevent shock. Attention should be paid to the change of urine output and the velocity of infussion should be adjusted. The doctors should be aware of the high incidence of shock when infants and children had a burn area exceeding 75% BSA. Colloidal and electrolyte infussion at the second 24 hours should be half of the amount for the first 24 hours. Water intake should be kept the same as for the first 24 hours. Application of MEBO is easy and simple. If no Shock and no septicemia occurred and the wounds were properly treated, the result will be very satisfactory.