肢体高压电烧伤临床诊断和治疗全国专家共识（2025版）

中华医学会烧伤外科学分会

doi:10.3760/cma.j.cn501225-20250109-00017

肢体高压电烧伤临床诊断和治疗全国专家共识（2025版）

doi: 10.3760/cma.j.cn501225-20250109-00017

中华医学会烧伤外科学分会

基金项目:

国家重点研发计划 2022YFC2403004

北京市自然科学基金-昌平创新联合基金 L234067

北京市医院管理局临床技术创新项目 XMLX201838

详细信息

通信作者：沈余明,首都医科大学附属北京积水潭医院烧伤科,北京 100035,Email：shenyuming1963@163.com

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出版历程
- 收稿日期: 2025-01-09

National expert consensus on the clinical diagnosis and treatment of high-voltage electrical burns in the limbs (2025 edition)

Funds:

National Key Research and Development Program of China 2022YFC2403004

Beijing Natural Science Foundation-Changping Innovation Joint Fund L234067

The Clinical Technology Innovation Project of the Beijing Municipal Health Bureau XMLX201838

摘要

摘要: 肢体高压电烧伤致残率高、截肢率高,多年来烧伤科医师积累了较为丰富的相关治疗经验,但并没有公认的肢体高压电烧伤诊断和治疗流程。为了规范肢体高压电烧伤的诊断和治疗,提高治疗水平,挽救濒临截肢的肢体,尽最大可能恢复患肢外观和功能,该共识编写组以循证医学证据为基础,德尔菲法为指导,围绕肢体高压电烧伤患者的诊断、急诊非手术处理、急诊手术处理、早期清创、早期修复、截肢决策、康复锻炼及功能重建、截肢后的假肢佩戴以及心理治疗,制订了《肢体高压电烧伤临床诊断和治疗全国专家共识（2025版）》,为全国烧伤整形外科、创面修复外科和急诊科等相关科室同仁对肢体高压电烧伤的诊断和治疗提供参考。
- 烧伤,电 /
- 四肢 /
- 外科皮瓣 /
- 清创术 /
- 康复 /
- 心理疗法 /
- 创面修复 /
- 专家共识
Abstract: High-voltage electrical burns in the limbs are associated with high disability and amputation rates. Over the years, burn specialists have accumulated extensive experience in treating such injuries, but there is no universally accepted diagnosis and treatment protocol for high-voltage electrical burns in the limbs. To standardize the diagnosis and treatment of high-voltage electrical burns in the limbs and improve treatment levels, as well as to save limbs at risk of amputation and restore the appearance and function as much as possible, this consensus writing group developed the National expert consensus on the clinical diagnosis and treatment ofhigh-voltage electrical burns in the limbs (2025 edition) based on evidence from evidence-based medicine and guided by the Delphi method. The consensus covered aspects such as diagnosis, emergency non-surgical management, emergency surgical management, early debridement, early repair, amputation decisions, rehabilitation exercises and functional reconstruction, prosthetic wearing after amputation, and psychological therapy for the patients with high-voltage electrical burns in the limbs. This consensus aims to provide references for colleagues in the fields of burn and plastic surgery, wound repair surgery, and emergency medicine across the country in the diagnosis and treatment of high-voltage electrical burns in the limbs.
- Burns, electric /
- Extremities /
- Surgical flaps /
- Debridement /
- Rehabilitation /
- Psychotherapy /
- Wound repair /
- Expert consensus
所有编写组成员声明不存在利益冲突,无商业组织向本共识编写组支付费用。本共识制订过程中需要的资金来自国家重点研发计划（2022YFC2403004）、2021年度北京市重大疫情防治重点专科卓越项目、北京市自然科学基金-昌平创新联合基金（L234067）、北京市医院管理局临床技术创新项目（XMLX201838）,用以承担制订过程中的科研费、材料费及项目组织实施等费用,且推荐意见未受资助影响

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Table 1. 2011版牛津大学循证医学中心证据等级标准

证据级别	具体描述
1级	基于随机对照试验或单人交叉临床试验的系统性文献回顾,对随机性研究的系统综述
2级	随机对照试验或效果显著的观察性研究
3级	非随机性、对照性队列研究或随访研究
4级	病例系列、病例对照研究或历史对照研究
5级	基于机制的推论