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患者男,54岁。1994年9月8日因汽油烧伤全身,伤后3小时急诊入院。入院时精神萎靡,肢端湿冷,尿少。面颈部、双下肢、躯干呈深Ⅱ度创面,双上肢创面皮革状,并可见树枝状血管栓塞。入院诊断:火焰烧伤全身82%,Ⅲ度20%。入院后追问病史无药物过敏史。入院后补液抗休克,创面清创后,除头面部暴露外均予1%SD-Ag 冷霜包扎,肌注 TAT,应用青霉素抗感染,休克期平稳渡过。伤后第3天改用万古霉素、泰能抗感染治疗。伤后第4、9天分别于全麻下行四肢切削痂、打洞大张异体皮覆盖和打洞异体皮嵌植自体皮术,躯干创面仍用1%SD-Ag 冷霜外用。伤后19天除腋下、
Male patient, 54 years old. September 8, 1994 because of gasoline burn the whole body, 3 hours after injury emergency admission. Apathetic admission, cold acral, oliguria. Face and neck, both lower extremities, torso was deep Ⅱ degree wounds, double upper limb leathery, and visible dendritic embolization. Admission diagnosis: flame burn 82% of the body, Ⅲ degree 20%. Question history after admission No history of drug allergy. After admission, rehydration anti-shock, wound debridement, except for head and face exposure were given 1% SD-Ag cold cream bandage, intramuscular injection of TAT, application of penicillin anti-infection, shock period to go through. On the 3rd day after injury, vancomycin was switched to Thai anti-infective treatment. On the 4th and 9th day after injury, the limbs were excised by cutting the limbs under general anesthesia. The holes were covered with large allogeneic skin and allogeneic skin implants were perforated. The torso wounds were still treated with 1% SD-Ag cold cream. 19 days after injury except armpit,