成批烧伤的救治

目的总结成批烧伤救治的经验。方法对１９９３年１１月～１９９７年５月救治的１０批烧伤事故共计４２例进行回顾性总结。结果４２例中Ⅲ度烧伤面积５０％以上者１５例；７０％以上者７例；９０％以上者３例。最大Ⅲ度面积９３％。烧伤总面积９０％以上同时Ⅲ度７０％以上者５例。除１例总面积７０％，Ⅲ度３０％于伤后３天死于ＡＲＤＳ，另１例总面积７０％，Ⅲ度７０％于伤后７天死于急性肾功能衰竭外，余４０例全部治愈。结论救治成批烧伤病人的技术力量必须前伸；航空救护有利于特重伤员的转运；休克期复苏尿量指标维持在５０～８０ｍｌ／ｈ可为后续治疗垫定一良好基础；大面积切痂植皮时间提前至伤后２～３天；建立“烧伤皮库”可为成批烧伤救治提供十分必要的异体皮保障。

Treatment of mass burns

Objective Present paper aims at summing up the experience from 42 cases over a four year period(19931997) in ten events of mass burn casualties. Methods 42 cases were analyzed retrospectively, in whom 15 cases sustained burn over 50% TBSA. Among them 7 cases had burn over 70% and 3 cases with burn over 90%. Results One case (70% TBSA) died of acute respiratory distress symdrome on third postburn day. Another (70%) died of acute renal failure on seventh postburn day. The remaining 40 cases were successfully cured. Conclusion Experiences gained in burn care in these ten mass casualties included:sending forward the medical expertise to the site of disaster; airlifting to accelerate transportation, adequate resuscitation in shock stage; early massive excision of eschar and skin grafting; control of burn infection; prevention of Curling ulcer hemorrhage, emphasis on supportive therapy; and the establishment of a skin bank.