深Ⅱ度烧伤创面伤后24小时内削痂的临床观察

目的　探讨深Ⅱ度烧伤患者伤后 2 4h内创面行削痂术的安全性和临床疗效。　方法12例有削痂手术指征并在伤后 2 4h内行削痂术的深Ⅱ度烧伤患者为A组 ;14例削痂条件相似并按常规在伤后 4～ 6d行削痂术的深Ⅱ度烧伤患者为B组。比较两组休克期补液量、休克征象发生率、回吸收期的生命体征、尿量及愈合时间。　结果　两组患者在休克期补液量、休克征象发生率方面差异均无显著性意义 (P >0 .0 5 ) ;A组休克期尿量明显增多 ,回吸收期的体温、心率与B组明显不同(P <0 .0 5～ 0 .0 1) ;A组创面平均愈合时间较B组短 (P <0 .0 1)。　结论　深Ⅱ度烧伤创面于伤后2 4h内削痂是安全的 ,并能缩短创面愈合时间。

Clinical observation of the effect of tangential excision within 24 postburn hours on the patients with deep partial thickness burn

OBJECTIVE: To investigate the safety and the clinical effect of the tangential excision of the patients with deep partial thickness burn within 24 postburn hours (PBHs). METHODS: Twelve patients with deep partial thickness burn with the indication for tangential excision, the operation was carried out within 24 PBHs. These patients were designated as group A. Another group of fourteen patients with similar conditions undergoing tangential excision during 4 - 6 PBDs were designated as group B. The amount of fluid infusion during shock stage, the shock signs, the vital signs during recovery period, the urine output, as well as the healing time were compared between the two groups. RESULTS: There was no obvious difference in the amount of fluid infusion and the shock signs between the two groups. There were evident differences in the body temperature and heart rate during recovery period, with the urine output increased dramatically during shock stage in group A when compared with those in group B (P < 0.05-0.01). The average wound healing days in group A were less than that in group B (P < 0.01). CONCLUSION: Tangential excision within 24 PBHs was applicable and safe for the patients with deep partial thickness burn, and wound healing time was thus shortened.