严重烧伤创面早期切痂植皮与并发症相关性研究

Correlation study on early removal of eschar and skin grafting and complication in serious burn wound

目的研究热带地区严重深度烧伤早期切痂植皮对提高治愈率、降低并发症的影响。方法收集1988年以来烧伤面积50%TBSA以上或Ⅲ度烧伤面积21%TBSA以上;小儿烧伤面积26%TBSA以上或Ⅲ度烧伤面积11%TBSA以上病例共计1856例。按其入院先后随机分成两组,治疗组采用切痂植皮1285例,对照组采用保痂治疗571例。结果两组成活率比较,治疗组成活率明显提高,内脏并发症明显低于对照组(P<0.01)。结论严重烧伤创面早期切除坏死组织以阻断毒素对机体的损害,对降低内脏并发症的发生、提高治愈率效果显著。

Objective To study effect of early removal of eschar and skin grafting on increasing cure rate and reduce complication in serious and deep burn in tropical area.Methods Since 1988,we have treated 1856 cases with serious and deep burn.Indclusion criteria were as follows：adult patients of TBSA more than 50% and Ⅲ degree more than 21%,infantile patients of TBSA more than 26% and Ⅲ degree more than 11%.The patients were allocated randomly into therapeutic group（1285 cases） and control group（571 cases） in accordance with admission order.Therapeutic group took removal of eschar and skin grafting.Control group retained eschar.Results The survival rate of therapeutic group was obviously superior to control group（P0.01）.The incidence of visceral complication of therapeutic group was obviously lower than control group（P0.01）.Conclusions In patients with serious burn wound,early removal of necrotic tissue can block injury effect of toxin,reduce incidence of visceral complication and increase cure rate.