招待講演２："The Extensive Burns Treatment in China"　 Yong Hua Sun, M.D. Professor Department of Burns & Plastic Surgery Beujing Ji-Shui-Tan Hospital 31 Xinjiekou East Main Street Beijing 100035, P.R.China ５月13日(水)　13:30〜14:20 司会：島崎 修次(杏林大学救急医学)

In China, thirty years ago the first extensive burn patient (TBSA 89% with 3rd degree injury 23%) was successfully treated which evoked strong repercussion in medical field nationwide . Since then, burns units were established in various places.According to the statistic result of some main burns centers Beijing, Shanghai, Chongqing and so on, 34,164 burns cases were admitted from 1958 to 1982. 31,818 cases were cured; the cure rate was 93.1%. Of those patients, 812 cases burn injuries were over 80% TBSA. 320 were survived with cure rate 39.41. The patients suffered TBSA over 90% with 3rd degree burns injuries more than 70% were 353 cases. In this group 52 cases were cured. Also, 10 cases with 3rd degree burn injuries over 90% were treated successfully. 　　Mortality of burn injuries has decreased markedly over the last decade. The statistic result of some main burn centers Beijing, Shanghai, Chongqing and so on, showed 50% fatality rate of second and deep second degree burn injuries was 90.2%, and 3rd degree was 61.3%. Handers of extensive burns patients with 3rd degree injuries more than 90% were survived. The treatment of extensive 3rd degree burned patients is a difficult clinical problem not only because of the physiologic abnormalities but also the small area of normal skin available to provide replacement of large area of skin destruction. 　　Our clinical experience is mainly based on better fluid resuscitation keeping the urinary output over 1 ml /kg/hr, control of local and systemic infection maintaining vital organs function and early surgical excision grafting with different effective methods. *TBSA indicates total body surface area.