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Clinical Application of MEBT/MEBO in Treating Upper Gastrointestinal Burn Injuries (2Cases Report Attached)
Add Time£º2011/12/5 13:51:04
                                                YAN Xin-lin
Affiliation: Department of Stomatology, The Armed Police General Hospital of Qinghai, Qinghai Province 810000, China
¡¾Abstract¡¿ Objective: To explore the feasibility of applying MEBT/MEBO in the treatment of upper gastrointestinal burn injuries. Methods: 2 cases with upper gastrointestinal burn injuries were treated simply with MEBO administered in ways of oral-containing and swallowing. Results: MEBO has potent analgesic effects, and the wounds got healed after 12 days treatment. No diarrhea, no scars and no dysfunction occurred. Conclusion: MEBT/MEBO is a new approach to treat upper gastrointestinal burn injuries.
¡¾Key words¡¿MEBO; Burn injuries; Upper gastrointestinal tract; Oral-containing and swallow administration
I. Case Report
Patient LI, Male, 18 years old, cook; Patient LU, Male, 19 years old, cook. In the afternoon of January 19th, 1997, they sucked hot marinade (106.30C) during the process of draining hot marinade from a 160cm diameter pot by using the ¡°siphon principle¡± improperly. They swallowed the marinade reflectively due to sever pain, which, consequently, led to severe burning pain at the epigastic and retrosternal region. Emergency treatment was done immediately at the scene. Physical examination results as follows: clear consciousness but a little nervous, diaphoresis and painful facial looking, speaking incapability. Exfoliated mucosa and the resulting tissue base exposure were seen on the perioral area, lip, mouth and tongue. The oropharynx mucosa was highly congested and very red, with varied sizes of transparent blisters. The patients were with obvious severe pain and rigid and tenderness-obvious abdominal muscle. Diagnosis: upper gastrointestinal burns.
¢ò. Methods and Effects
Both of the patients were given 20g of MEBO 10 minutes after burn in the way of firstly oral-contain MEBO in the mouth for a while and then slowly swallowed it. The oral pain was relieved immediately and the pain in the sternum and epigastric region was also relieved after 10 minutes treatment. And MEBO was administered once every 2 hours. 6 hours after burn, patient¡®s lip, mouth, tongue and base of the mouth swelled highly and were getting worse. They had such symptoms of mild dyspnea as chin disappearing and long respiration. So we observed the patients closely and made preparations for tracheostomy. MEBO was continuously used to control the conditions of the patients. At 24 hours after burn, patients improved a lot with smooth respiration and can take in liquid diet. And then, MEBO was administered once every 4 hours. At the seventh day of the treatment, swelling was disappeared completely with normal mucosa on the oral cavity. However, the uvula of one case became smaller than before with uneven surface and harder texture but without pronunciation disturbance. And then MEBO was applied 4 times per day. Changed dressing regularly for the perioral burn until wound healing 12 days after treatment.
The wounds of the patients obtained spontaneous healing. Body temperature taken during the course of treatment was 37.5 0C, and the overall conditions of patients were well with WBC8.0-11.2x109/L and without toxic granulation and water or electrolyte imbalance. Patient can have liquid diet between treatment intervals and each of them swallowed a total of 1300g MEBO but without the occurrence of diarrhea. No other treatments like analgesics, IV solution and antibiotics as well as tracheostomy were performed throughout the whole course of treatment. Patients recovered at the 12 days after treatment and no signs of scar formation and dysfunction were observed by gastroscopy at the 3 months follow-up.
¢ó. Discussion
Upper gastrointestinal burn injuries are not uncommon in clinic, especially the oral mucosa burn injury. Patients would suffer from more pains and the wound healing would be delayed, and even complications may occur if the interventions were improper or ignored. MEBO application on 2 cases of upper gastrointestinal burn patients has shown favorable effectiveness without the occurrence of complications, of which the advantages are summarized as follows:
1.       MEBO with its unique patented dosage form is a direct intervention for upper gastrointestinal burn. MEBO being an ointment with net framework structure, hydrophilic and containing abundant nutrients but no contraindications for oral administration [1] are the theoretical foundation of it to be used in a way of oral-containing and swallowing as well as direct smearing on the wound in clinic. Thus, MEBO intervention is a brand new approach to treat the upper gastrointestinal burn injuries.
2.       MBEO has immediate and reliable analgesic effects. Pain relief can be achieved 10 minutes after MEBO oral-containing/swallowing. Many nerve endings are distributed in the oral mucosa, thus patient will feel severe pain after burn injuries. However, when MEBO was smeared on the wound surface, it would function to drain the exudates continuously and protect the wound surface from the stimulation of the nerve endings, so as to fulfill the analgesic effects. Ingredients contained in MEBO with the function of activating blood and dissolving stasis can improve microcirculation stasis, which is in line with the theory of ¡°stasis leads to pain and pain relieves after stasis dissolves¡± in the traditional Chinese medicine [2].
3.       MEBO provides a physiological environment for wound repair [3]. MEBO is effective in inhibiting bacterial growth in that a protective membrane will be formed after MEBO application in ways of oral-containing and swallowing to prevent the invasive infection of bacteria. In addition, MEBO can function to remove the necrotic tissues and promote granulation tissue growth, by which the exudates together with the necrotic tissues after such reactions as hydrolysis, saponification, esterification and etc. were removed out of the wound without damage in the way of ¡°spontaneous drainage¡±. Thus, a favorable environment for tissue growth and repair is provided.
4.       The ingredients of MEBO provide nutritional support for the body. The active ingredients of MEBO include polysaccharides, lipid, protein and etc. which can provide nutritional support for the body when MEBO takes effects on the wound in ways of oral-containing and swallowing, without the discomforts such as diarrhea and others.  
5.       It is worthy to promoted and popularized with the advantages of easy operation, less pain and less cost.
[1] Collective Paper from The Chinese Science and Technology Center for Burns, Wounds & Ulcers. Summative Report on the Clinical Trials of MEBO: Multi-Center Study [J]. The Chinese Journal of Burns Wounds & Surface Ulcers, 2000, (2):13.
[2] SHA Guang-xi. Clinical Study Report of MEBO in the Treatment of 1550 Burn inpatients [J]. The Chinese Journal of Burns Wounds & Surface Ulcers, 1998, (4):31.
[3] XU Rong-xiang. General Introduction to the Burns Wounds & Ulcers Medicine [J]. The Chinese Journal of Burns Wounds & Surface Ulcers, 1989, (1): 20.
¡¾About the Author¡¿
YAN Xin-lin (1968~): Male (Han); Chief Physician of Stomatological Department; born in Qingdao City, Shandong Province; graduated from Qinghai Medical College.

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