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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。BurnClassificationNote:Thelistbelowshows4burndegrees.Whilemostofthepublicdoesnotrecognizethe4thdegree,itisthecorrectterm.Thetablebelow,with3degrees,isalsocorrect.Bothareacceptable.Determiningburndepthisimportant.Thingstoconsideraretemperature,mechanism,durationofcontact,bloodflowtoskin,andanatomiclocation.Epidermaldepthvarieswithbodysurface,whichcanoffervaryingdegreesofthermalprotection.Olderadultsandyoungchildrenalsohavethinnerskin.Firstdegree:Includesonlytheouterlayerofskin,theepidermisSkinisusuallyredandverypainfulEquivalenttosuperficialsunburnwithoutblistersDryinappearanceHealingoccursin3-5days,injuredepitheliumpeelsawayfromthehealthyskinHospitalizationisforpaincontrolandmaybefluidimbalanceSeconddegree:Canbeclassifiedaspartialorfullthickness.PartialthicknessBlisterscanbepresentInvolvetheentireepidermisandupperlayersofthedermisWoundwillbepink,redincolor,painfulandwetappearingWoundwillblanchwhenpressureisappliedShouldhealinseveralweeks(10-21days)withoutgrafting,scarringisusuallyminimalFullthicknessCanberedorwhiteinappearance,butwillappeardry.InvolvesthedestructionoftheentireepidermisandmostofthedermisSensationcanbepresent,butdiminishedBlanchingissluggishorabsentFullthicknesswillmostlikelyneedexcision&skingraftingtohealThirddegree:AlllayersoftheskinaredestroyedExtendsintothesubcutaneoustissuesAreascanappear,blackorwhiteandwillbedryCanappearleatheryintextureWillnotblanchwhenpressureisappliedNopainFouthdegree:Fullthicknessthatextendsintomuscleandbone.Burninjuryisthedestructionofthelayersoftheskinandassociatedstructures.AnatomyofSkin: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:Ⅱ°面积9%中度烧伤:Ⅱ°面积10%-29%Ⅲ°面积不足10%重度烧伤:总烧伤面积达30%-49%或Ⅲ°面积达10%-19%Ⅱ°、Ⅲ°烧伤并休克、吸入性损伤特重烧伤:总烧伤面积50%Ⅲ°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、颈部有深度烧伤*呼吸道刺激症状:声哑、呼吸困难、哮鸣音、咳炭末样痰特殊类型烧伤的特点1,电击伤:“入口”损伤比“出口”严重“入口”皮肤焦裂样洞穴出入口之间深部组织不规则进行性坏死局部反应重、全身反应轻2,化学烧伤硫酸、硝酸、盐酸、石碳酸等少见水疱皮革样焦痂创面蜡白/青灰色疼痛剧烈
本文标题:烧烫伤的程度划分中英文
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