肿胀技术在稳定大面积危重烧伤患者早期手术中血流动力学的作用
he role of tumescent technique in stabilizing hemodynamics in early operation of massively burned patients
摘要：目的：探讨大面积危重烧伤病人早期手术中运用肿胀技术的临床效果。方法：选择2019年6月-2022年11月符合纳入标准的大面积烧伤患者27例为研究对象，对其进行回顾性队列研究，其中，2021年6月-2022年11月收治的14例患者应用术区注射肿胀液法止血，设为肿胀组；2019年6月-2021年11月收治的13例患者运用止血带法止血，设为止血带组。比较两组患者手术时间、出血量、术前计划输血量、实际输血量、术前及术后血红蛋白、术中及术后血压、心率、术后植皮存活率等相关指标，观察其临床效果。结果：两组患者术前计划输血量差异无统计学意义（P＞0.05），肿胀组实际输血量少于止血带组，差异有统计学意义（P＜0.05）；肿胀组术中失血量、手术时间明显少于止血带组，差异有统计学意义（P＜0.05），肿胀组及止血带组的术前与术后血红蛋白均无明显差异（P＞0.05）；肿胀组术后植皮存活率略高于止血带组，差异有统计学意义（P＜0.05）。肿胀组患者术中生命体征较止血带组平稳，差异有统计学意义（P＜0.05）。结论：肿胀技术在大面积危重烧伤病人早期手术中具有减少术中出血量、缩短手术时间、提高术后植皮存活率，同时保证了大面积烧伤患者术中血流动力学稳定，具有较好的临床效果。
Objective: To explore the clinical effect of tumescent technique in early operation of massively burned patients. Methods: A retrospective cohort study was conducted on 27 patients with large area burns accorded with the inclusive criteria and admitted from June 2019 to November 2022. Among them, 14 patients admitted from June 2021 to November 2022 were treated with intraoperative injection of tumescent fluid for hemostasis and were rolled in tumescent group, or observation group; 13 patients admitted from January 2019 to November 2021 were treated with tourniquet for hemostasis were rolled in tourniquet group, or control group. The operation time, blood loss, blood preparation, blood transfusion, preoperative and postoperative hemoglobin, intraoperative and postoperative blood pressure, heart rate, postoperative skin graft survival rate and other related indicators were compared between the two groups, and the clinical effects were observed. Results: There was no statistical difference in preoperative blood volume between the two groups (p > 0.05). The actual amount of blood transfusion in the observation group was less than that in the control group, and the difference was statistically significant (p < 0.05). The intraoperative blood loss and operation time in the observation group were significantly less than those in the control group, and the difference was statistically significant (P 0.05). The survival rate of skin grafting in the observation group were slightly higher than those in the control group, and the difference was statistically significant (P < 0.05). The vital signs of patients in the observation group were more stable than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion: Tumescent technique can reduce the amount of intraoperative blood loss, shorten the operation time, improve the survival rate of postoperative skin grafting, and ensure the stability of intraoperative hemodynamics in early operation of massively burned patients.
刘军、王辉、陈艳、路若楠
临床医学外科学
肿胀技术烧伤外科手术术中应用出血量临床效果
tumescent techniqueburnsurgical operationintraoperative applicationblood lossclinical effect
刘军,王辉,陈艳,路若楠.肿胀技术在稳定大面积危重烧伤患者早期手术中血流动力学的作用[EB/OL].(2023-11-12)[2025-08-21].https://chinaxiv.org/abs/202311.00234.点此复制
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