熱傷の臨床病理

CLINICAL PATHOLOGY OF BURN

I．はじめに

　熱傷，就中重症患者の予後は急救処置の良否と密接な関係がある。従つて熱傷の治療は患者から可及的速やかに治療に必要な資料を収集することが肝要であるが，一般に治療の対象となる患者の大半は乳幼児で，しかも既にショックに陥つている場合が多く，臨床検査の困難な場合が少なくなく，熱傷の臨床病理の実態を把握出来る機会は意外に少ない様である。事実筆者らも表記のテーマを頂いて早速教室の症例を蒐集したが，後述する如く十分検査を実施した症例は甚だ少なくやむを得ず，西日本各大学の御協力を仰いで，漸く9例を得ることが出来た。か様に考えると今回のパネルディスカションに熱傷を加えられたことは甚だ有意義と考える。

Prognosis of burn, especially that of severe case, depends on the treatment of emergency in its early stage. For this it is very important to get enough laboratory informations from the patient as fast as possible. However most of the patients are babies or children with the critical condition, and it is rather difficult to perform laboratory tests to them.

The author had 12 cases of severe burn for 2 years. The laboratory tests which were performed within one week after burn were the simple tests such as hemogram, Hct. determination and urinalysis. In 2 out of 3 cases of severe burn which resulted in death, no laboratory tests were performed, because too much emergency treatments were needed.

The author collected 7 cases from the departments of dermatology of university hospitals in southern part of Japan, and made analysis on the changes of blood picture, hematcrit value, protein ion and nonprotein nitrogen level of serum and protein content of urin within one week after burn. Summarization and comment on the relationships between these results from laboratory tests and systemic condition were reported.