矿井下高压电烧伤的紧急救治

Under Mine Pit Electrocution Burns

目的探讨矿井下高压电烧伤的现场急救和临床治疗措施,以降低患者致残率,减少病死率,提高患者预后生活质量,减轻伤痛。方法2002-2006年对38例矿井下高压电烧伤患者,早期积极现场急救,根据病情严重程度,接受早期液体复苏,纠正休克,保护心、肾、脑等重要内脏,按电烧伤创面进行临床分型,早期行切痂、削痂、自体皮片移植覆盖和皮瓣/肌皮瓣转移修复,挽救肢体功能,恢复外观形态,减少烧伤毒素吸收再损伤。结果本组38例患者经过治疗无一例死亡,其中36例患者治疗后生活完全自理,受损伤肢体功能和外观恢复良好（Ⅰ型8例,Ⅱ型14例,Ⅲ型4例）;1例Ⅲ型肢体电烧伤外观恢复良好,功能恢复较差,需要功能重建;1例Ⅳ型肢体电烧伤肢体无法修复,早期截肢,经安装假肢,生活亦能自理。结论矿井下高压电烧伤患者经过积极有效的现场急救,正规系统的临床治疗可得到满意治疗效果,愈后致残率、病死率较低,对保护矿工生命和提高愈后生活质量具有重大意义。

Objective To research scene first aid and the clinical remedial measure of high - voltage burn personnel under the mine pit, to reduce casualty cripplingrate, reduces the mortality rate, improve the quality of Life after recovery, reduces the grief. Methods To early positive scene first aid 38 cases of the high - vohageburn patient from 2002to 2006, according to the severity of burns give the formal system of early fluid resuscitation correcting shock to protect heart, kidney, brain and other important internal organs, carries on the clinical minute according to the electricity burn injured area, The early time cuts the scab, truncates the scab, autologous skin graft coverage and the flap / myocutaneous flap repair, Save the limb function, resume appearance, reduce the injury caused by absorption of toxins. Results The group of 38 patients after treatment, no patient died, 36 examples completely take care of themselves, injured limb function and appearance has a good recovery （ type Ⅰ 8cases, type Ⅱ 14 cases, typeⅢ 4 cases） A case of type Ⅲ has well physically appearance recovered, poor functional recovery, needs reconstruction. A case of type Ⅳ, the physically is unable to resume early amputees, prosthetics, life can also be themselves. Conclusion Under the mine pit the high - voltage burn patients through active and effective scene first aid under the systematic clinical treatment can both get satisfactory results, morbidity and mortality rates were much greatly lower. It is of great significance for the quality of life after recovery and protection of the worker under the mine pit.