烧烫伤的程度划分 中英文.doc

烧烫伤的程度划分: 一、I度烧烫伤（红斑性烧伤）:伤及皮肤表皮，表现为受伤处皮肤轻度红、肿、热、痛，感觉过敏，无水泡;3-7天愈合，不留瘢痕。二、（1）浅II度烧烫伤（水疱性烧伤）:伤及真皮乳头层，水疱较大，疱壁厚，基地潮湿，表现为受伤处皮肤疼痛剧烈、感觉过敏，有水泡;水泡拨离后可见创面均匀发红、潮湿、水肿明显; 2周愈合，不留瘢痕，可有色素沉着。（2）.深II度烧烫伤:伤及真皮深层，创面水疱较小、疱壁厚，去皮后基地红白相间，可见网状血管栓塞。表现为受伤皮肤痛觉较迟钝，可有或无水泡，基底苍白，间有红色斑点;拔毛时可感觉疼痛;3-4周痊愈，留有瘢痕。三、 III度烧烫伤（焦痂性烧伤）:伤及皮肤全层，达肌肉或骨骼层，皮肤感觉消失，无弹性，干燥，无水泡，蜡白、焦黄或碳化;拔毛时无疼痛。严重的烧伤不仅损伤皮肤，还可深达肌肉、骨骼甚至引起全身变化如休克感染等。愈合慢，愈合后疤痕增生。Burn ClassificationNote: The list below shows 4 burn degrees. While most of the public does not recognize the 4th degree, it is the correct term. The table below, with 3 degrees, is also correct. Both are acceptable.Determining burn depth is important. Things to consider are temperature, mechanism, duration of contact, blood flow to skin, and anatomic location. Epidermal depth varies with body surface, which can offer varying degrees of thermal protection. Older adults and young children also have thinner skin.First degree:Includes only the outer layer of skin, the epidermisSkin is usually red and very painfulEquivalent to superficial sunburn without blistersDry in appearanceHealing occurs in 3-5 days, injured epithelium peels away from the healthy skinHospitalization is for pain control and maybe fluid imbalanceSecond degree: Can be classified as partial or full thickness.Partial thicknessBlisters can be presentInvolve the entire epidermis and upper layers of the dermisWound will be pink, red in color, painful and wet appearingWound will blanch when pressure is appliedShould heal in several weeks (10-21 days) without grafting, scarring is usually minimalFull thicknessCan be red or white in appearance, but will appear dry.Involves the destruction of the entire epidermis and most of the dermisSensation can be present, but diminishedBlanching is sluggish or absentFull thickness will most likely need excision & skin grafting to healThird degree:All layers of the skin are destroyedExtends into the subcutaneous tissuesAreas can appear, black or white and will be dryCan appear leathery in textureWill not blanch when pressure is appliedNo painFouth degree: Full thickness that extends into muscle and bone.Burn injury is the destruction of the layers of the skin and associated structures.Anatomy of Skin:烧伤的致伤原因1， 热力（热水、蒸汽、火焰）2， 化学物质（强酸、强碱）3， 电4， 放射线烧伤的病理生理分期1， 休克期：伤后48-72h内 大量体液渗出，2-3h最快，8h达到高峰，48h开始回吸收，此期易发生低容量性休克。2， 感染期：72h后 皮肤生理屏障被破坏。创面、渗液黎宇细菌生长繁殖，产生毒素。感染烧伤创面脓毒症。3， 修复期：伤后5-8天开始 I度烧伤，3-7天自行修复。浅II度烧伤，2周愈合，有色素沉着。深II度烧伤，3-4周愈合，留有瘢痕。III度烧伤，靠皮肤移植修复，留有瘢痕，影响功能。临床表现和诊断1， 烧伤面积：手掌法：伤员本人五指并拢的手掌面积为体表总面积的1%, 五指自然分开的手掌面积为1.25%，适用于小面积烧伤的评估。2， 九分法：烧伤的严重程度：根据烧伤深度与面积判断轻度烧伤：面积50% 20%或已有严重并发症吸入性损伤诊断依据：*吸入火焰、蒸汽、浓烟等*燃烧现场相对封闭*口鼻周围、面、颈部有深