Zhou Yi-Ping, Ren Jia-Liang, Zhou Wei-Ming, Yang Lei, Wu Yong-Heng, Chen Jing, Wang Jia-Han
Burn Unit, Nanfang Hospital, First Military Medical University, Mei Hwa Yuan, Guangzhou 510515, Peoples Republic of China.
Asian J Surg. 2002 Apr;25(2):154-6. doi: 10.1016/S1015-9584(09)60165-2.
The objective of this study was to explore our experience in the treatment of serious burn patients (total burn surface area [TBSA] > 90% and full thickness burns > 70% TBSA).
Thirty patients who were admitted to our unit over a period of 12 years were analyzed retrospectively; 23 cases (76.7%) were successfully treated.
There were seven out of 12 cases (58.3%) in the first 5 years and 16 out of 18 cases (88.9%) in the latter 7 years of the study period.
It is concluded that: 1) giving electrolyte-free fluids (around 3700 ml) and the maintenance of hourly urine output at 70 ml or more appear to be beneficial in resuscitation therapy; 2) the first operative procedure should be undertaken early, at about the third day after injury; 3) a higher percentage area of eschar to be excised in the first operation is encouraged and eschar excision of up to 40% or more is preferable; 4) controlling the area of exposed wound under 5% in the entire therapeutic course is essential in the prevention of burn infection; 5) emphasis should be placed on the vital role of a dehumidifier in reducing the incidence of fungal infection; and 6) early enteral nutrition with the use of growth hormone in correcting the nutritional state of the patient is also emphasized.
本研究的目的是探讨我们在治疗严重烧伤患者（烧伤总面积[TBSA]>90%且全层烧伤>TBSA的70%）方面的经验。
回顾性分析12年间收治于我院的30例患者；23例（76.7%）成功治愈。
在研究期间的前5年，12例中有7例（58.3%），后7年，18例中有16例（88.9%）。
得出以下结论：1）给予无电解质液体（约3700ml）并将每小时尿量维持在70ml或以上似乎有利于复苏治疗；2）首次手术应尽早进行，约在受伤后第三天；3）鼓励在首次手术中切除更高比例的焦痂，切除高达40%或更多的焦痂更可取；4）在整个治疗过程中将暴露创面面积控制在5%以下对于预防烧伤感染至关重要；5）应强调除湿机在降低真菌感染发生率方面的重要作用；6）还强调早期肠内营养联合使用生长激素以纠正患者的营养状况。
