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目的探讨烧伤后期发生应激性溃疡的原因及防治措施。方法分析25例大面积烧伤患者受伤2周以后发生应激性溃疡出血,甚至消化道穿孔的临床资料。结果因消化道大出血直接导致死亡12例,出血控制后感染加重死亡5例,溃疡穿孔导致死亡2例,治愈生存6例。结论烧伤后期仍有发生应激性溃疡的危险,应采取心理调节、营养支持、防治感染、尽快消灭创面、重视围手术期防范等预防性措施。一旦发病需要进行长时间综合治疗,当反复出血,甚至穿孔时应果断施行包括手术的侵入性治疗。
Objective To investigate the causes of post-burn stress ulcer and its prevention and treatment. Methods The clinical data of 25 cases of extensive burn patients who suffered from stress ulcer hemorrhage and even digestive tract perforation after 2 weeks’ injury were analyzed. Results 12 cases were directly caused by hemorrhage of digestive tract, 5 cases died of infection after hemorrhage control, 2 cases died of ulcer perforation and 6 cases survived. Conclusions There is still a risk of stress ulcer in the late stage of burn. Psychological adjustment and nutritional support should be taken to prevent and cure infection and destroy the wound as soon as possible. Preventive measures such as perioperative prevention should be emphasized. Once the disease requires a long time comprehensive treatment, when repeated bleeding, and even perforated should be decisive implementation of invasive treatment, including surgery.