大面积烧伤休克期切痂植皮时机的临床指标

为无监测条件下开展休克期切痂的同行提供一些实且的临床观察指标。方法 总结了６０例休克期切痂病人的临床经验。结果 提出了选择休克期切痂时机的临床观察指标。１．第一个２４小时放量２．６－３．０ｍｌ．ｋｇ＾－１，１５ＴＢＳＡ＾－１；２尿量８０－１００ｍｌ／小时，３；意识清楚；４．口渴明显减轻，无恶心呕吐；５．心率１００次／分左右；．６血红蛋白≤１５０ｇ／Ｌ，７红细胞压积≤０．５０。

Clinical guidelines for timing of escharectomy and skin grafting during burn shock stage in extensively burned patients]

OBJECTIVE: To provide practical clinical guidelines to doctors who have no hemodynamic monitoring facilities in performing escharectomy during the shock period in extensively burned patients. METHODS: We analyzed our clinical experiences in 60 patients with extensive burn. RESULTS: Puting forward several clinical indexes for timing of escharectomy during burn shock stage: 1. Amount of fluids in the first 24 h postburn 2.6-3.0 ml.kg-1.1% TBSA-1; 2. Output of urine 80-100 ml/h; 3. Mentally fully conscious; 4. Thirst significantly alleviated and there is no nausea and vomiting; 5. Pulse 100/min; 6. Hb < or = 150 g/L; 7. Hct < or = 0.50. CONCLUSION: With the clinical indexes as guidelines, we assume that escharectomy could be performed during burn shock stage with reasonable safety.