危重烧伤患者功能和容貌恢复情况调查和分析.docVIP

危重烧伤患者功能和容貌恢复情况调查和分析 　　[摘要]目的:探讨Ⅲ度烧伤面积≥90%TBSA(the total body surface area,TBSA,体表总面积)危重烧伤患者治愈后生活质量。方法:回顾分析随访1977年～2008年间抢救成功的13例Ⅲ度烧伤面积90%TBSA烧伤患者整形修复手术的时间、次数以及广泛增生性瘢痕对机体产生的影响等问题。结果:13例患者中有11例作过多次整形或美容修复手术,9例生活能自理,4例需要部分护理依赖,2例并发瘢痕癌。结论:危重烧伤特别是Ⅲ度烧伤面积≥90%TBSA患者自体皮源奇缺,给救治和整复手术带来了极大的困难,早期功能部位修复手术和功能锻炼可提高患者功能与容貌等生活质量。 　　[关键词]Ⅲ度烧伤面积≥90%TBSA;功能;容貌;随访 　　[中图分类号]R644[文献标识码]A[文章编号]1008-6455(2010)03-0315-03 　　 　　Follow-up study of function and aesthetic recover of patients with severe burns 　　CHEN Cun-fu1,WANG De-chang2,WANG Ke-hua1,YU Ren-yi1 　　(1.Department of Burn and Plastic Surgery,PLA General Hospital,Jinan 250031,Shandong,China; 2.Department of Burn and Plastic Surgery,Shandong Provincial Hospital,Jinan 250021,Shandong,China) 　　 　　Abstract:ObjectiveTo summarize the life quality of patients with full thickness burns ≥90%TBSA cured.Methodsretrospective analysis and follow-up visit were performed to the patients with full thickness burns ≥90%TBSA , who were cured from 1977 to 2008. The time of plastic surgery,operation times and Undesirableoutcome because of extensive hypertrophic scar.Results11 cases of the 13 patients underwent series of plastic surgery,9 of them were life independent,4 of them were partial life independent,and 2 of them developed scar cancer.Conclusionextreme difficlties come into being because of deficiency of autodermic skin source to patients with burns≥90%TBSA. Plastic surgery to functional sites and function exercise benefit the life quality. 　　Key words: full thickness ≥90%TBSA; function; aesthetic; follow-up visit 　　 　　目前,危重大面积深度烧伤,尤其是Ⅲ度烧伤面积90%TBSA (the total body surface area,TBSA,体表总面积)的烧伤患者死亡率依然很高,治疗难度很大。抢救成功的少见病例,多并发严重的功能障碍、容貌毁损,生活质量不高等问题。笔者对1977～2008年共31年间济南军区、山东省立等5所医院抢救成功的13例Ⅲ度烧伤面积90%TBSA患者进行了调查随访,现将有关情况报道如下。 　　 　　1临床资料 　　本组13例中男11例,女2例,除1例59岁外,其中12例平均年龄为(25±5.0)岁,其中9例为工人,3例为农民,1例为渔民。13例患者烧伤面积(总面积%/III度%)分别为95/90、98/94、96/90、99/94、96/92、98/92、97/93、97/90、98/90、97/90、100/94,96/92、92/90,平均总面积:(96.85±1.99)%,III度面积:(91.62±1.71)%