Guo Z R
Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1993 Jan;9(1):5-8, 77.
In order to stop excessive plasma loss, to alleviate noxious effects of devitalized tissues on the body, and to shorten the hospitalization time, we have attempted to perform extensive escharectomy during the shock period in extensively burned patients. Group 1 consisted of 17 patients, aged 19 to 45 years, with mean total burn area 58 +/- 15.9% TBSA, and full-thickness injury involving 32.0 +/- 17.2% TBSA. The first escharectomy was done at 26.2 +/- 14.6 h postburn, and excision area averaged 32.0 +/- 7.1% (24% to 46%). In 13 of them, Swan-Ganz catheter was introduced to monitor the hemodynamic changes. It was found that RAP, PAP, PAWP, ABP, HR, CO and CI were all stable during and after the operation. Group 2 consisted of 29 patients, in whom escharectomy was begun 4-5 days postburn. The mean healing time of the patients in group 1 was 31.7 days, which was shorter than that of group 2 (40.1 days). The duration of hemoconcentration was shorter in group 1. The amount of blood transfusion was almost 1000 ml less in group 1 during the first two weeks. Less antibiotics were used with fewer visceral complications in group 1. The authors believe that escharectomy during the burn shock stage is feasible.
为了阻止过多的血浆丢失，减轻失活组织对机体的有害影响，并缩短住院时间，我们尝试对大面积烧伤患者在休克期进行广泛的焦痂切除。第一组由17例患者组成，年龄19至45岁，平均烧伤总面积为58±15.9%TBSA，Ⅲ度烧伤面积为32.0±17.2%TBSA。首次焦痂切除在伤后26.2±14.6小时进行，切除面积平均为32.0±7.1%（24%至46%）。其中13例患者置入Swan-Ganz导管以监测血流动力学变化。结果发现，术中及术后RAP、PAP、PAWP、ABP、HR、CO和CI均保持稳定。第二组由29例患者组成，在伤后4至5天开始进行焦痂切除。第一组患者的平均愈合时间为31.7天，短于第二组（40.1天）。第一组血液浓缩持续时间较短。在前两周内，第一组的输血量比第二组少近1000毫升。第一组使用的抗生素较少，内脏并发症也较少。作者认为在烧伤休克期进行焦痂切除是可行的。
