烧烫伤的程度划分 中英文
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 Classification
Note: 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 epidermis
Skin is usually red and very painful
Equivalent to superficial sunburn without blisters
Dry in appearance
Healing occurs in 3-5 days, injured epithelium peels away from the healthy skin
Hospitalization is for pain control and maybe fluid imbalance
Second degree: Can be classified as partial or full thickness.
Partial thickness
Blisters can be present
Involve the entire epidermis and upper layers of the dermis
Wound will be pink, red in color, painful and wet appearing
Wound will blanch when pressure is applied
Should heal in several weeks (10-21 days) without grafting , scarring is usually minimal
Full thickness
Can be red or white in appearance, but will appear dry.
Involves the destruction of the entire epidermis and most of the dermis
Sensation can be present, but diminished
Blanching is sluggish or absent
Full thickness will most likely need excision & skin grafting to heal
Third degree:
All layers of the skin are destroyed
Extends into the subcutaneous tissues
Areas can appear, black or white and will be dry
Can appear leathery in texture
Will not blanch when pressure is applied
No pain
Fouth 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：Ⅱ°面积
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