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目的探讨严重烧伤后的病生理、烧伤后微循环障碍以及烧伤后凝血-抗凝系统紊乱的变化。严重烧伤后血液的高凝状态、血管完整性的破坏,使烧伤患者成为深静脉血栓(DVT)的高危人群。方法烧伤治疗的全过程都要预防和治疗DVT形成,早期扩容、抗凝药物应用、减少静脉反复穿刺抽血及反复深静脉置管、长期卧床患者主动及被动的局部锻炼等,减少和避免DVT的发生,早期诊断也是避免DVT脱落造成患者死亡的关键。结果应用小剂量抗凝药物或者中药活血化瘀制剂可以有效防治DVT,同时采取物理治疗、主动及被动锻炼、早期明确诊断等,能有效避免DVT及其引发的严重后果。结论重视严重烧伤后DVT,可以减少重症烧伤致命性DVT的发生,提高治愈率。
Objective To investigate the changes of physiology, pathophysiology after severe burn, microcirculation after burn, and coagulation-anticoagulation system disorder after burn. The hypercoagulable state of the blood after severe burns and the destruction of the vascular integrity make the burned patients become a high risk population of deep vein thrombosis (DVT). Methods The whole process of burn treatment should prevent and treat the formation of DVT, early dilatation, anticoagulant application, repeated venous puncture and repeated catheterization of deep venous catheter, active and passive local exercise in long-term bedridden patients to reduce and avoid DVT The occurrence of early diagnosis is also the key to avoid the patient died of DVT shedding. Results The application of low-dose anticoagulant drugs or traditional Chinese medicine promoting blood circulation and removing blood stasis preparations can effectively prevent and treat DVT. At the same time, physical therapy, active and passive exercise, early definite diagnosis and so on can effectively avoid DVT and its serious consequences. Conclusion The emphasis on severe post-burn DVT can reduce the incidence of fatal DVT in severe burn and improve the cure rate.