中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (5): 464–466.doi: 10.12007/j.issn.0258-4646.2016.05.021

• 论著 • 上一篇    下一篇

成批大面积烧伤合并烟雾吸入性肺损伤的救治分析

孙亚楠,刘晓虹,孙树   

  1. 中国医科大学附属第一医院普通外科,烧伤科,沈阳 110001
  • 收稿日期:2016-03-03 出版日期:2016-05-30 发布日期:2016-05-09
  • 通讯作者: 孙树 E-mail:sunshu99 @sina.com
  • 作者简介:孙亚楠(1982 -),女,主治医师,博士.
  • 基金资助:
    辽宁省临床能力建设项目(青年)(LNCCC-D01-2015)

Acute Lung Injury after Extensive Burn Merging Smoke Inhalation:Treatment in 32 Cases of Early Stage

SUN Yanan,LIU Xiaohong,SUN Shu   

  1. Department of General Surgery,Burn Ward,The First Hospital,China Medical University,Shenyang 110001,China
  • Received:2016-03-03 Online:2016-05-30 Published:2016-05-09

摘要: 目的 总结成批大面积烧伤合并烟雾吸入性肺损伤的早期救治经验,为进一步提高临床早期救治成功率提供参考。方法 选择 2014 年 11 月至 12 月我科参与救治的因矿井爆炸所致大面积烧伤合并烟雾吸入性肺损伤患者 32 例,对其早期救治、 分流及预后情况(伤后 1 个月)进行分析。结果 32 例患者中,2 例在休克期因呼吸衰竭死亡。休克期后(伤后第 3 日)对患者进 行分流,19 例就地治疗,11 例病情相对稳定者分流至附近医院。1 个月后随访结果显示:就地治疗重患死亡 2 例,其余 28 例患者 伤后 1 个月内均存活。结论 除早期积极抗休克、气管切开、抗感染、创面切痂植皮手术及营养支持外,在抗休克治疗结束后, 及时分流伤情允许的患者至有救治条件的附近医院,是此次救治成批大面积烧伤合并烟雾吸入性肺损伤获得成功的关键。

关键词: 成批烧伤, 大面积烧伤, 烟雾吸入性急性肺损伤, 分流, 灾难医学

Abstract: Objective To summarize the treatment experience of extensive burn merging smoke inhalation acute lung injury(SIALI)in 32 early stage cases,and to provide a reference for the further improvement of success rate in early stage. Methods A total of 32 cases of extensive burn merging SIALI resulting from mine explosion that received clinical treatment and triage from November to December in 2014 were enrolled for the study. In addition,the experience of triage and prognosis(after injured in a month)to guide therapy was analyzed. ResultsTwo of the 32 patients died from respiratory failure in shock period,after shock period(3 days after injured),19 bad sufferers were cured in the local hospital,and the other 11 cases in stable condition were triaged to the nearby hospital. 1 month follow-up results showed that:patients who received therapy in local hospital,one died from MODS in 3 weeks,one died from kidney failure in 4 weeks. The other 28 patients were alive. Conclusion For these patients who suffering from extensive burn merging SIALI received therapy in early stage,we should not only schedule positive anti-shock,tracheotomy, antibiotics,escharectomy and nutritional support or other treatments,but also face to the challenge of lacking medical resources from too more patients. Thus,we suggest to triage the wounded to nearby hospital after anti-shock treatment,so as to improve the success rate in early stage.

Key words: mass burns, extensive burn, smoke inhalation acute lung injury, triage, disaster medicine

中图分类号: 

  • R644
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[2] 马超群,杨旸,袁玉会,于宏伟. 腹腔镜辅助下脑室腹腔分流术治疗脑积水的体会[J]. 中国医科大学学报, 2016, 45(2): 183-184.
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