大面积烧伤并发应激性溃疡出血的临床分析

Clinical Experience Analysis of Stress Ulceration being Complicated by Extensive Burn.

目的:探讨大面积烧伤并发应激性溃疡出血的病因、发病机制、诊断、治疗及预防措施。方法:对47例烧伤病例的临床资料进行回顾性分析及文献复习。结果:本组病例中,41例经保守治疗出血控制,其中13例反复出血;手术治疗6例;1例合并败血症死亡;1例术后再次发生严重出血休克并发DIC死亡;其余均获得痊愈。结论:大面积烧伤后积极防治休克,控制感染,早期进食,应用抑酸药物,是防治烧伤后应激性溃疡出血的有效方法;并发应激性溃疡出血以内科保守、内镜下或介入治疗为主,必要时辅以手术治疗。

Objective： To approach the etiopathgenisis of stress ulceration complicated by extensive burn, diagnosis, treatment and preventive measures. Method： Retrospective analysis and the literature reviewing were made with 47 cases records. Results： 41 of 47 cases were in conservative treatment to control bleeding, in which 13 cases were still in repeat bleeding. While other 6 cases were performed with operation , in which 1 case died in septicemia and 1 case died in bleeding shock complicated with DIC after operation. Rest others, all healed. Conclusion： It is an effective way of preven- ting and treating stress ulceration complicated by extensive burn to prevent/treat shock actively, to control infection effectively, to feed food at earlier stage and to apply the drugs of restraining acidum. The stress ulceration complicated by extensive burn should be mainly treated with conservative treatment and interventional therapy under endoscope. When necess ry, it is better to use surgical operation to assist the treatment.