Guo S S, Greenspoon J S, Kahn A M
Department of Surgery, UCLA School of Medicine, Los Angeles, CA 90073, USA.
Burns. 2001 Jun;27(4):394-7. doi: 10.1016/s0305-4179(00)00128-5.
Burns suffered during pregnancy is rare and can be a devastating injury. The presence of a fetus creates many special maternal physiological changes, and the burn wound places additional great stress on systems that are already highly modified. Most of the literature has come from developing countries, and most reports from developed countries have come before 1980 and do not reflect the current standard of care. We have compiled a retrospective review of eight patients burned during pregnancy. The total body surface area (TBSA) burned ranged from 1 to 85% in these patients, and all survived the injury. All patients gave birth to healthy children except the most severely burned patient, whose child suffers from cerebral palsy. Based on our experience as well as a review of the literature, management recommendations are proposed. These include: (1) early pregnancy test for all female patients of childbearing age, (2) prompt and aggressive fluid resuscitation, (3) early supplemental oxygen and low threshold for mechanical ventilatory support, (4) early delivery of the fetus if the pregnancy is in the third trimester, and (5) high suspicion for venous thrombosis and sepsis, with early and aggressive treatment.
孕期烧伤较为罕见，且可能是一种严重的损伤。胎儿的存在会引发许多特殊的母体生理变化，而烧伤创面会给本就已发生高度改变的身体系统带来额外的巨大压力。大部分相关文献来自发展中国家，发达国家的多数报告则出自1980年以前，无法反映当前的护理标准。我们对8例孕期烧伤患者进行了回顾性研究。这些患者的烧伤总面积（TBSA）在1%至85%之间，且均从烧伤中存活下来。除了烧伤最严重的患者孩子患有脑瘫外，所有患者均产下健康婴儿。基于我们的经验以及文献回顾，提出了管理建议。这些建议包括：（1）对所有育龄女性患者进行早期妊娠检测；（2）迅速且积极地进行液体复苏；（3）早期补充氧气并降低机械通气支持的阈值；（4）如果妊娠处于晚期则尽早分娩胎儿；（5）高度怀疑静脉血栓形成和败血症，并进行早期且积极的治疗。
