摘要
目的为无监测条件下开展休克期切痂的同行提供一些实用的临床观察指标。方法总结了60例休克期切痂病人的临床经验。结果提出了选择休克期切痂时机的临床观察指标:①第一个24小时入量2.6～3.0ml·kg^(-1)·1％TBSA^(-1);②尿量80～100ml/小时;③意识清楚;④口渴明显减轻,无恶心呕吐;⑤心率100次/分左右;⑥血红蛋白≤150g/L;⑦红细胞压积≤0.50。结论根据这些临床指标实施休克期切痂植皮手术是安全的。
Objective To provide practical clinical guidelines to doctors who have no hemody- namic monitoring facilities in performing escharectomy during the shock period in extensively burned pa- tients. Methods We analyzed our clinical experiences in 60 patients with extensive burn. Results Put- ing forward several clinical indexes for timing of escharectomy during burn shock stage: ①Amount of fluids in the first 24h postburn 2.6～3.0ml·kg^(-1) 1% TBSA^(-1); ②Output of urine 80～100ml/h;③ Mentally fully conscious ; ④Thirst significantly alleviated and there is no nausea and vomiting; ⑤Pulse 100/min; ⑥Hb≤150g/L; ⑦Hct≤0.50. Conclusion With the clinical indexes as quidelines, we assume that escharectomy could be performed during burn shock stage with reasonable safety.
