烧伤冷伤专题知识讲座.pptxVIP

烧伤冷伤专题知识讲座Bra C@M BoJwj Ami Mt? WrarfTissue injury caused by heat is called burn(including scald )Burn in cammen at ordinary times or in war. At ordinary times, scald is the greater part of burn. On the other hand, burn offer happens in war. According to degree of injury and difference of body reaction, burn can be classified into three stage in clinical process. At the same time, the three stage connects with each other and couldnot be distinguished entirely. I shockstage. It is hypovolemic shock, II, infective stage. The infective incidence is the hignest in two weeks post burn, III, repairation stage. Wound begin to repair soon after burn happed. In our country thetreatment level of burn comes up to advanced world standards. Most Vnits cured many patients of exceeding IHO SBA 90%. The total cure rate amount to over 95%, we maintain that patients with large burn area and deep degree burn should be carried out remaval of eschar and skingrafting in batches and by stages. The result was satisfied.Key words: burn, cold injury, bite wound, scald, shock, repairation wound, eschar, skin grafting.第一节热烧伤(Lesson One Burn)烧伤临床过程及病理生理特点(-)体液渗出期(休克期)[Acute humoral exadative stage (shock stage)](二) 急性感染期(Infectious stage)(三) 创面修复期(Repairation stage)(四) 康复期临床表现和诊疗(-)烧伤面积和烧伤深度估量1.面积 估量(Estimate of burn area)(1)中国新九分法亞(2)手掌法2.深度 估量(Judgemet of burn depth)三度四分法!1!(二)烧伤严重程度(Degree of burn)新九分法部位占成人体表％占儿童体表％发部头颈｛面部颈部33} 939+（12_.年龄）双上肢双上臂 双前臂 双手76} 9/259X2驱干躯干前 躯干后 回阴1313 9X3 .19液双下肢 双臀 双大腿 双小腿 双足521 9X5+1137 ”9%5+1.（12—年龄）现场抢救（Emergency treatment, transportation and primary treatment.）（一） 灭火（二） 灭火后处理（二）中、重度烧伤 早期处理1. 处理程序2. 烧伤休克防治⑴补液诊疗①补液公式：伤后第一个二十四小时补液量：U!成人每1%烧伤面积（II、HI0 ） X 0. 5ml胶体X lml电解质另加水分 ml烧伤后切痂(1)4. 自、异体（异种）皮相间混植5. 大张异体（异种）皮开洞嵌植点状自体皮6. 微粒皮移植7. 网状皮移植8. 培养表皮细胞膜片移植9. 人体“皮库”-头皮（四）感染创面处理植皮（游离皮片移植2）?自体游离皮片制作与移植:大 面积深度烧伤创面需尽早、立即 清除坏死组织，立即用自体皮、 自体皮加异体皮覆盖，切削痂后 新鲜创面或经清创后肉芽创面 尽可能不暴露为好。植皮（游离皮片移植3）?:?小皮片制作：取头皮或自体 皮之刃厚皮，真皮面朝上平铺 于抗菌素湿沙上，剪成 0