350例烧伤早期体温与血象变化原因分析

An Analysis of the Causes of Change in Blood Picture and Body Temperature at the Early Stage of Burn

作者观察总结了350例烧烫伤病人入院早期的体温与血象的变化。临床实践中发现湿疗法较传统疗法患者体温上升快、早，持续时间短。绝大部分患者伤后4～6小时即出现高体温，最高达40．8℃，高热时患者神志清、精神、食欲等均良好。采取一定措施后高热即可下降。血象均较正常明显增高，白细胞总数最高达31．9～40×109／L，中性粒细胞0．90，一般患者入院时均在13～18×109／L，中性粒细胞0．80～0.90。临床中发现白细胞早期低于10×109／L以下伴低体温的患者予后均欠佳，尤其是婴幼儿。早期体温与血象的变化反应了机体受创伤后免疫功能应激状态的变化。同时也反应了体温变化与创面用药和创面处理有密切关系，处理方法的正确与适当直接影响患者的病情变化，正确的处理可使体温与血象多在3～5天左右控制在理想的范围内，个别病例最长在一周内得到稳定。

The authors observed the changes in body tem-perature and blood picture of 350 cases of burn at theearly stage and found that burn patients treated withMEBT had their body temperature rise and return tonormal, earlier and quicker than those treated withconventional method. Most of the patients treatedwith MEBT had their body temperature rise appearedat 4 to 6 hours post burn, the highest could reach40℃. But the patients were in a state of good con-sciousness and had good appetite. Their body tem-perature returned to normal after appropriate treat-ment. Blood picture of the patients showed that theWBC count amounted to 31. 9 to 40 ×109/L, neutralgranulocyte 0. 90. Most of the patients upon hospital-ization had WBC count of 13 to 18 ×109/L, neutralgranulocyte 0. 80 to 0. 90. Patients, especially in-fants, whose WBC count was fewer than 10× 109/L atthe early stage and had lower body temperature oftenhad unfavorable prognosis.Changes in body temperature and blood picture atthe early stage reflect the immunity and stress func-tion of the patient post burn and are closely related tothe effect of the drug applied and the treatment of thewound. Proper treatment of the wound helps to con-trol body temperature and btood picture in a favorablerange and to be stabilized within a period no longerthat a week.