应用湿润烧伤膏治疗面部Ⅱ度烧伤的疗效观察

目的探索面部Ⅱ度烧伤的最佳疗法.方法对我院1998年1月至2004年5月收治的烧伤患者中随机抽取了143例烧伤患者进行调查分析.对目前常用的湿润烧伤膏(MEBO)治疗(M组)和磺胺嘧啶银(SD-Ag)干燥暴露治疗(S组)、0.5%碘伏(PVP-I)半暴露治疗(I组)进行对比分析.结果 M组平均创面愈合时间15.3 d,色素改变10/51,瘢痕形成3/51,创面感染2/51.均低于S组和 I组.结论 MEBO对面部Ⅱ度烧伤的治疗优于SD-Ag干燥暴露和0.5% PVP-I半暴露疗法.     

严重烧伤合并多脏器功能衰竭81例分析

目的:对严重烧伤并发多脏器功能衰竭的诱发因素和发生规律进行探讨和分析,提高治愈率。方法:通过对81例严重烧伤后多脏器功能衰竭的病例的回顾性分析,对多脏器功能衰竭的诱发因素和发生规律进行探讨和研究。除伤情严重外,吸入性损伤、休克和败血症是多脏器功能衰竭的主要诱发因素。结果:81例多脏器功能衰竭的发生率和病死率与烧伤的严重程度以及休克、吸入性损伤和败血症等诱发因素直接相关。结论:对多脏器功能衰竭的预防是治疗的关键     

人工皮肤的研究进展

早期切痂术使用人工皮肤代用品迅速覆盖创面 ,对提高大面积烧伤病人的生存率有重要意义 ,但是 ,迄今为止 ,尚无一种持久、合适耐用的皮肤代用品。因此 ,建立一种理想的皮肤代用品 ,无论是对急性烧伤病人 ,还是伤后要求皮肤修复重建的病人都有重大作用。本文将临床上所使用的各种皮肤代用品的特性、使用情况和作用机制进行综述 ,并对人工皮肤代用品将来的研究发展方向进行展望     

海南地区6160例小儿烧伤发病规律的分析

目的 分析海南地区12岁以下小儿烧伤的发病规律。方法 对6160例小儿烧伤的年龄分布、烧伤原因、烧伤程度及季节分布进行统计分析。结果 年龄以1～3岁居多，占39．31％；烧伤原因以热液烫伤为主，占68．76％；烧伤程度以中度烧伤为主，占41．56％；季节分布，从高到低依次为第二、四、三、一季度。结论 要高度重视幼儿烧伤的防治，特别要预防热液烫伤。     

Delayed appearance of decorin in healing burn scars

AIMS: We have previously shown that hypertrophic scar tissue from burn patients contains abnormally high amounts of the proteoglycans versican and biglycan and reduced amounts of decorin, in comparison with normal dermis or mature scar. The lack of decorin may account for the poor organization of collagen fibrils in the nodular areas of these scars. Decorin has also been reported to neutralize the fibrogenic growth factor TGF-beta1. This study was conducted to monitor the time-course of expression of decorin in healing burn wounds by in-situ hybridization to determine whether its absence from hypertrophic scars could result from reduced synthesis. METHODS AND RESULTS: Scar tissue from 19 patients and normal dermis from six patients, was fixed in paraformaldehyde, embedded in paraffin and sectioned. Digoxigenin-labelled cRNA probes were prepared from a plasmid containing a 622-bp insert of human decorin cDNA and used for in-situ hybridization. Total numbers of connective tissue cells and cells positive for decorin mRNA were counted in 10 random fields in the upper (papillary), middle and lower (reticular) one-thirds of the dermis. In all regions the number and percentages of cells with decorin mRNA were low during the first 12 months after injury (eight samples), much higher between 12 and 36 months (seven samples) and low and similar to those in normal skin after 36 months (five samples). The differences between intermediate and early or late stage samples were statistically significant (one-way ANOVA). Immunohistochemistry showed little staining for decorin in early stage samples and much stronger staining in mid-stage. Late stage tissue showed intense staining for decorin, almost comparable to that in normal dermis. CONCLUSION: Expression of decorin in burn wounds is suppressed for about 12 months and then increases at a time when resolution of hypertrophic scarring is generally considered to occur.     

Peripheral vascular permeability following a thermal injury to the airway

Effects of thermal injury to the airway on the vascular permeability in the region of head and neck, were studied in the canine models. The thermal airway injury was produced by an inhalation of a gas burners flame through the metallic tracheostomy cannula. The changes in vascular permeability were evaluated by calculating the reflection coefficient, which was obtained by the protein washdown technique into lymph. The reflection coefficient after the flame inhalation did not show any increases, while it increased significantly after a histamine infusion into the carotic artery. We concluded, that the vascular permeability in the unburned area does not increase at least in the first 3hr after a thermal injury to the airway.(Okamoto K, Noguchi H, Akashi M, et al.: Peripheral vascular permeability following a thermal injury to the airway. J Anesth 5: 79–87, 1991)     

高钙对烧伤早期豚鼠离体心脏固有收缩性的影响

为了探讨烧伤早期心肌固有收缩力降低的机制,本实验观察了35％体表面积Ⅲ度烧伤后8小时,灌流豚鼠离体心脏对高钙溶液(含Cacl_2 3.2mmol/L台氏液)的反应及对Ca~(2+)的消耗量。结果表明,烧伤组在高钙液灌流情况下,左心室内压的±dp/dtmax、心室肌细胞动作电位幅度,最大去极化速率.复极化50％的时程缩短程度均低于对照组(P<0.05);对常钙或高钙灌流液中Ca~(2+)的交换量,烧伤组也显著低于对照组(P<0.01)。提示烧伤早期心肌细胞对Ca~(2+)的摄取、利用,心肌细胞电位对Ca~(2+)的反应均低于正常,这可能是此期心肌固有收缩性和舒张功能显著降低的重要原因之一。     

Changes in contractile activity of the rabbit myocardium as a result of burn shock of varied duration

Experiments were carried out on papillary muscles isolated from the rabbit heart 10, 60, or 180 min after thermal injury to the animal. Isometric contractions were recorded during stimulation of the preparation at changing frequencies (within the range from 0.1 to 2 Hz) and during poststimulation potentiation. The degree of disturbance of myocardial contractility as a result of burns was found to increase with an increase in the duration of burn shock: In all the papillary muscles isolated 3 h after burning and in 50% of those isolated 1 h after burning the biphasic frequency-strength (f-P) relationship characteristic of the normal myocardium was converted into monophasic (the amplitude of the contractions decreased progressively with an increase in frequency) and poststimulation potentiation, normally absent, appeared. After shock lasting 10 min, poststimulation potentiation was observed only in some preparations and no change in f-P was present. The normal inotropic relationships of the myocardial rhythm were restored after a twofold increase in [Ca⁺⁺]₀ or after prolonged (3–4 h) perfusion of the preparation with normal Tyrode solution. Changes in inotropic relationships of the myocardial rhythm in burn shock were similar to the changes in f-P observed after blockade of the calcium channels with compound D-600.Laboratory of Physiology and Laboratory of Biophysical Research, A. V. Vishnevskii Institute of Surgery, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Sciences of the USSR V. N. Chernigovskii.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 87, No. 5, pp. 402–405, May, 1979.     

一氧化氮在烧伤小鼠腹腔巨噬细胞功能调节中的作用

作者探讨了烧伤时小鼠腹腔巨噬细胞（MΦ）产生一氧化氮（NO）、TNF-α及PGE_2的影响,以及烧伤活化的MΦ通过产生的NO对其本身功能的调节作用。实验发现烧伤早期MΦ能产生过量的NO、TNF及PGE_2,其中以NO产生较早,PGE_2产生较晚。NO的产生与iNOS活性呈明显正相关。iNOS特异性阻断剂甲基精氨酸（NMMA）能使NO产生明显下降,同时还使TNF-α及PGE_2产量分别卜降42. 9％和52. 8％,但对iNOS活性无影响。     

Effects of new wound dressings on healing of thermal burns of the skin in acute radiation disease

Effects of new wound dressing bacterial cellulose impregnated with SOD and poviargol (Procel-Super and Procel-PA) and Inerpan hydrogel dressing on the reparative processes in deep dermal burns (IIIa–IIIb degree) in rats exposed to total even irradiation in a dose of 4 Gy were studied. Inerpan and Procel-Super dressings proved to be the most effective under these conditions: they accelerated healing of burn wounds by 17.0 and 5.5%, respectively.Translated from Byulleten Eksperimentalnoi Biologii i Meditsiny, Vol. 138, No. 9, pp. 351–355, September, 2004