成批烧冲复合伤的早期抢救

Early treatment of multiple patients with extensive burns combined with burst injury of the lung

目的探讨成批特重烧冲复合伤早期救治和转运分流的组织实施经验。方法总结和分析抢救一批16例特重烧冲复合伤伤员临床资料和转运分流的组织管理做法。结果本组伤员中1例伤后5d死于重度肺爆震伤,1例伤后20d因全身多脏器功能衰竭死亡,其余14例生命征平稳,恢复顺利,烧伤创面愈合良好。伤员抢救的组织实施严密,后勤保障及时有力,转运分流过程安全顺利。结论在严密临床观察基础上进行个体化补液,早期气管切开,选择合适的机械通气模式,重视改善通气换气功能是早期治疗特重烧冲复合伤的有效方法。制定有针对性的应急抢救预案,有力的后勤保障,及时分流转运伤员有助于提高成批伤员的救治成功率。

Objective To explore effective treatment methods and experience of management and organization in the early period of multiple patients with extensive burns combined with blast injury of the lungs. Methods To summary and analyze the climical date of 16 patients with extensive burns the combined with blast injury and experience of management and organization. Results One patient died of severe blast injury of lung 5 days after, one died of multi-organ dysfunction syndrome, the others recovered well and the burn, healed well. Organization and the course of resuscitating patients were effective, logistic support was strong and all patients were transported and transferred successfully. Conclusion Individualization fluid infusion based on exact clinical observations and increaseing the ratio of colloid fluid would help to prevent shock accompany burst injury of lung. Early and suitable mechanical ventilation mode to improve ventilation/gas exchange function were important measures to manage inhalation injuries. To plan directive salvage schemes for emergency and powerful logistic support, and transporting and transferring patients in time would help to increase treatment efficiency of multiple patients.