早期切痂对重度烧伤患者静息能量消耗的影响

目的:探讨早期切痂对重度烧伤患者静息能量消耗(REE)的影响.方法:回顾性分析我院2002年6月～2010年6月期间收治的120例重度烧伤患者的临床资料,按照实施切痂植皮时机不同分为观察组(伤后早期切痂)84例和对照组(非早期切痂)36例,清创后均行暴露疗法,切痂时将Ⅲ度及其周围深Ⅱ度创面全部切除,然后采用自体皮片覆盖...

Effect of early excision of eschar on resting energy expenditure of patients with severe burns

Objective： To investigate the effect of early excision of eschar on resting energy expenditure（REE） of patients with severe burns.Methods： Clinical data of 120 severe burn cases admitted from June 2002 to June 2010 were retrospectively analyzed.They were randomly divided into observation group（84 cases） and control group（36 cases） based on the time of excision and skin graft.The exposure therapy was carried out after debridement,and wounds at Ⅲ level and deep Ⅱlevel were completely excised.Then the wound was covered by autologous skin.REE was monitored by metabolism cart（MedGraphics Company,USA）.The levels of IL-6 and TNF-α were determined by ELISA,LPS by azoic color method,and ALT by automatic biochemistry analyzer.Results： REE level in two groups were increased,and there was no significant difference in REE between two groups after 1d,2d and 3d（P〈0.05）.It was significantly higher in observation group after 5d,7d and 14d（P〈0.05）,while the levels ofIL-6,TNF-α,LPS and ALT were significantly lower in control group（P〈0.05）.Conclusions： Early excision of eschar can alleviate high metabolic state,reduce levels of inflammatory cells and liver injury,which be associated with releasing of inflammatory mediators.