Kaddoura I, Abu-Sittah G, Ibrahim A, Karamanoukian R, Papazian N
Division of Plastic & Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Plastic & Reconstructive Surgery, Kare Plastic Surgery & Skin Health Center, Santa Monica, California, USA.
Ann Burns Fire Disasters. 2017 Jun 30;30(2):95-102.
Despite a considerable decrease in their incidence worldwide, burn injuries remain one of the commonest forms of trauma and account for a weighty proportion of trauma cases in health-care emergencies around the globe. Although the latest data reveal a substantial decline in burn-related mortality and hospital admissions in the US over the past three decades, severe thermal injuries continue to trigger devastating morbidity and significant mortality while their management remains a dynamic challenge for the entire medical and paramedical community. Concrete evidence continues to be established regarding burn-associated pathophysiologic responses, and their destructive sequelae and deleterious effects in survivors at cellular, systemic as well as socio-economic level. Better understanding of these responses have contributed to advances in therapeutic strategies, improved long-term outcomes and catalyzed the reintegration of victims back into society. This paper describes the current understanding of the pathophysiology of a burn injury and characterizes both local and systemic pathophysiologic responses in terms of metabolic, hemodynamics, cardiac, renal, hepatic, gastro-intestinal, immunologic, endocrine as well as male reproductive systems in an attempt to understand the corresponding treatment modalities for this unique patient population.
尽管全球范围内烧伤的发生率大幅下降，但烧伤仍是最常见的创伤形式之一，在全球医疗紧急情况中的创伤病例中占很大比例。尽管最新数据显示，在过去三十年中，美国与烧伤相关的死亡率和住院率大幅下降，但严重热损伤仍会引发毁灭性的发病率和显著的死亡率，而对其的治疗仍是整个医疗和辅助医疗界面临的动态挑战。关于烧伤相关的病理生理反应及其在细胞、全身以及社会经济层面给幸存者带来的破坏性后遗症和有害影响，仍在不断积累确凿的证据。对这些反应的更好理解推动了治疗策略的进步，改善了长期预后，并促进了受害者重新融入社会。本文描述了目前对烧伤病理生理学的理解，并从代谢、血流动力学、心脏、肾脏、肝脏、胃肠道、免疫、内分泌以及男性生殖系统等方面，对局部和全身的病理生理反应进行了描述，旨在了解针对这一特殊患者群体的相应治疗方式。
