山东省泰山医学院附院、泰山烧伤中心(271000)

    王广顺 徐西胜 李承存 孔杰 杨玉风 左春霞 刘霞

    〔摘 要〕 收治一例延期入院的成人特大面积烧伤，烧伤总面积91%，其中浅Ⅱ°18%，深Ⅱ°25%，Ⅲ°48%。伴吸入性损伤、烧伤休克、低蛋白血症及红细胞聚集症等。经正规化的MEBT/MEBO治疗，并辅以“耕耘”疗法等，创面愈合较快，抗休克首先重视强心，保护肾功能，补液按“缺多少，补多少”的原则，使每小时尿量大于50ml。抗感染除强化创面处理外，预防性抗生素只使用9天，以后视伤员意识障碍、高体温、中性粒细胞出现中毒颗粒等情况，短程静脉滴注复达欣等广谱抗生素。病人救治成功，也由于全疗程重视了营养支持和对内脏功能的保护。

    〔关键词〕 特大面积烧伤 吸入性损伤 MEBT/MEBO

    A Patient with 91%TBSA Burn (Ⅲ°48%) Complicated by Inhalation Injury Cured by Treating with MEBT/MEBO Wang Guangshun, et al. Affiliated Hospital, Taishan Medical College, Shandong Province, 271000 〔Abstract〕 A patient with 91%TBSA burn, among them superficial second degree 18%, deep second degree 25% and third degree 48%, complicated by inhalation injury, shock, hypoproteinemia and hemagglutination, was treated with MEBT/MEBO in a proper way and associated with "ploughing and weeding"therapy. The wounds healed quickly. Anti-shock measures including cardio-tonic, renal function protecting and fluid infusion to keep the urine volume no less than 50 ml/hour, etc. were adopted. Anti-infection measures included the application of antibiotics for 9 days for preventive purpose and then intravenous infusion of broad spectrum antibiotics when necessary. Sufficient nutrition support and protection of organ function played a very important role in the successful treatment of the patient. 〔Key words〕 Exceptionally large area burn inhalation injury MEBT/MEBO ......