MEBT-MEBO治疗浅Ⅲ度烧伤护理体会.docVIP

MEBT/MEBO治疗浅Ⅲ度烧伤护理体会 　【摘要】 目的 总结采用湿润暴露疗法及湿润烧伤膏（美宝）治疗浅Ⅲ度烧伤的护理体会。方法 对20例浅Ⅲ度烧伤住院患者全程规范运用MEBT/MEBO治疗，对深度创面进行早期耕耘减张处理；同时做好休克期、创面、基础护理、心理护理、营养支持等环节的护理。结果 20例患者创面全部愈合，无一例植皮。创面愈合时间最短40天，最长64天，平均48天，均达到生理性愈合，无畸形，无功能障碍。结论 浅Ⅲ度烧伤运用MEBT/MEBO治疗，配合合理正确的护理方法，可提高治愈率，促进创面再生修复。 【关键词】 Ⅲ度烧伤；MEBT/MEBO；护理 Nursing experience with MEBT/MEBO in treating superficial third degree burn 【Abstract】 Objective To sum up in the nursing of superficial third degree burn treated with MEBT/MEBO.Methods 20 cases of superficial third degree burn were treated with MEBT/MEBO in the whole treating course in a standardized way，for deep burn wounds, ploughing method was applied to reduce tension. Nursing measures for every link in the treatment were taken, including shock stage nursing, wound, basic nursing, psychological nursing and nutrition support, etc.Results All the cases were cured. No skin grafting was needed, The shortest wound healing time was 40 days, the longest 64 days, and the average wound healing was 48 days. All the wounds healed physiologically, no deformity and no functional disturbance occurred.Conclusion MEBT/MEBO is very efficacious in treating superficial third degree burn. Rational and effective nursing work can promote the curative rate and wound healing. 【Key words】 superficial third degree burn; MEBT/MEBO;nursing 我科自2001年1月～2005年1月，先后收治浅Ⅲ度烧伤病人20例，全程规范运用湿润暴露疗法及湿润烧伤膏（美宝）治疗，结合抗感染及营养支持，同时做好休克期创 面基础及心理等环节的护理，使患者均得以顺利康复，取得 满意的疗效，现将护理体会总结报告如下。 1 临床资料 20例烧伤患者中，男12 例，女8例；年龄18～46岁，平均年龄32岁。烧伤面积最大70%，最小60%；致伤因素：爆竹炸烧伤12例，火焰烧伤8例；烧伤深度：Ⅱ度伴有Ⅲ度混合型8例，单纯性浅Ⅲ度12例。 2 护理 2.1 休克期护理 患者入院后立即建立静脉通道，在无皮肤损伤处用静脉留置穿刺或行静脉切开快速输液，原则上晶体液与胶体液按比例输入。同时给予夫雷氏导尿管保留导尿。严密监测体温、脉搏、呼吸、血压及每小时尿量变化，准确记录出入量，根据生命体征变化，验血结果和尿量，随时调整输液速度和液体种类。并静脉滴注高效、广谱足量的抗生素如头孢哌酮/舒巴坦或头孢唑肟钠等，时间3～7天。 2.2 创面护理 全组均系统应用MEBT/MEBO规范治疗。对浅Ⅲ度创面早期用耕耘刀减张，在消毒病房进行，不需麻醉，每天1～2次，连续3天。处理后即涂抹MEBO，厚1mm，每隔4h涂药1次。每次涂药前可用消毒压舌板轻轻刮涂或用无菌纱布或消毒卫生纸粘除原有药液与渗出物、液化物以及坏死组织；动作要轻柔，尽量做到不出血、不疼 痛、不损伤创面的正常组织，始终保持创面湿润均匀而不浸渍，确保创面引流通畅。根据创面渗出期、液化期和修复期的不同，调整MEBO的用量和涂药的间隔，直到创面完全愈合［1］，床上铺一次性