手部深度烧伤的临床评估与早期治疗

Clinical evaluation and early treatment of hand deep burns

手部深度烧伤(HDB)是造成烧伤尤其是严重烧伤患者残疾的主要原因之一。HDB的有效治疗需要烧伤、整形、康复和物理治疗等多学科理念与技术的整合应用。其早期的精准治疗是手部功能达到最佳恢复的基础,治疗目标包括有效预防继发性损伤、尽早封闭创面和早期功能康复等。本文基于循证医学原则,复习相关文献并结合山东大学附属济南市中心医院烧伤整复外科实践,分析总结HDB的临床病理特点,临床评估及减压治疗、早期切除与皮肤(瓣)移植、围手术期处理与早期功能康复的经验。

Hand deep burns(HDB)is one of the main reasons for resulting in physical disabilities of patients with burns,especially serious burns.Effective treatment of HDB requires the integrated application of multidisciplinary ideas and technical approaches,including burns,plastic surgery,rehabilitation medicine and physical therapy.Early accurate treatment of HDB is the basis for the best recovery of hand function.The treatment goals include effective prevention of secondary injuries,early wound closure and early functional rehabilitation,etc.This article is based on the principles of evidence-based medicine,reviewing relevant literature and combining with the practice of Department of Burns and Plastic Surgery,Jinan Central Hospital,Cheeloo College of Medicine,Shandong University,to analyze and summarize the clinical and pathological characteristics of HDB,clinical evaluation and decompression treatment,early resection and skin(valve)transplantation,surgical treatment and early functional rehabilitation experience.