小儿烧伤脓毒症53例的治疗体会

目的总结小儿烧伤脓毒症的防治经验。方法 2006年1月～2010年12月我院收治小儿烧伤1106例,发生脓毒症53例。对53例患儿脓毒症的发生原因、防治措施进行分析和总结。结果脓毒症发生率4.8%,休克、感染、吸入性损伤、营养不良等是脓毒症发生的主要原因;经积极抗休克治疗、加强创面处理和抗感染、脏器功能保护、营养支持等综合治疗,治愈45例,转院1例,死亡7例,病死率13.2%,主要死因是脓毒症并发的MODS。结论提高对小儿烧伤脓毒症的认识、积极有效复苏、对深度烧伤创面早期切（削）痂植皮、及时切除感染灶、合理使用抗生素、加强脏器功能保护和营养支持等综合治疗,能有效提高小儿烧伤脓毒症的治愈率。

The experience of the prevention and treatment of children with burn sepsis

Objective To sum up the experiences of the management of 53 children with burn sepsis.Methods 1106 children with burn were admitted to our hospital from January 2006 to December 2010,and among them 53 patients developed sepsis.To analyze the causes of sepsis and the measures of the prevention and treatment of postburd sepsis.Results The incidence and mortality of sepsis were 4.8%,13.2% respectively.Burnshock,infection,inhalation injury and malnutrition were the main causes which produced sepsis.45 cases survived and 7 patients died by giving immediate fluid resuscitation,correct treatment of wounds,appropriate application of antibiotics,reinforcement of organ support and application of nutrition support.Conclusion We believe that the the cure rate of children with postburd sepsis can be extremely improved by early comprehensive clinical measures,such as increasing the knowledge of postburd sepsis,rapid and adequate fluid resuscitation for burnshock,effective control of infetion,early excision of deep burn wounds followed by good skin coverage,timely excision of invasive burn wound infection,reinforcement of organ support and application of nutrition support.