大面积烧伤病人休克期切痂植皮的临床观察

The observation of tangential excision and skin grafting in large-area burn patients in shock stage

目的 探讨大面积烧伤病人切痂植皮时机的选择。方法 将 15例行切痂植皮的大面积烧伤病人随机分为两组 ,治疗组 8例行休克期切痂植皮治疗 ,对照组 7例休克期过后 (即非休克期 )行切痂植皮治疗。观察两组病人伤后第 3天的生命体征、尿量、输血量、并发症 ,住院天数及治愈率。结果 治疗组比对照组伤后第 3天生命体征平稳 ,术中每 1%切痂面积输血量少 ,并发症少 ,住院天数少 ,无死亡病例 ,治愈率高。结论 休克期切痂及早地去除了坏死组织 ,减轻了机体中毒反应 ,降低了感染发生率 ,从而提高了治愈率 ,对成功救治大面积烧伤病人极为有益。

Objective To investigate the opportunity of tangential excision and skin grafting in large area burn patients in shock stage.Methods Fifteen cases of large area burn patients received tangential excision and skin grafting were divided randomly into treatment group(8 cases) and control group(7 cases).Tangential excision and skin grafting were performed in shock stage in treatment group and after shock stage in controls.The vital signs 3 days after injury,urine,blood transfusion,complications,days in hsopital and heal rate were observed in all patients.Results The vital signs,blood transfusion,complications,time in hospital and curative rate in treatment group were all better than those in control group.Conclusion Tangential excision and skin grafting in large area burn patients in shock stage can decrease the physical metabolism and poisonous reaction to the body and therefore can incrase the curative rate with less infection by means of removing the necrotic tissue as soon as possible.It is beneficial to the treatments of large area burn patients.