摘要
目的探讨煤矿爆炸烧伤的特点,以求提高治愈率。方法通过临床病人的前瞻性规范治疗和回顾性观察,进行分析研究。结果煤矿爆炸烧伤以机械性损伤为早期死亡的主要原因,冲击伤以肺损害为主,CO中毒发生的机会较少,吸入性损伤主要是上呼吸道,MSOF受累最多的系统和脏器是呼吸系统和肾脏,MSOF的主要类型是肺+肾脏。全身侵袭性感染的主要细菌是肠道杆菌科的细菌和绿脓杆菌。结论煤矿爆炸烧伤是以烧伤病理变化为主的复合伤,有瓦斯和煤尘爆炸两种类型,并发MSOF及感染有其特点。渗出期补液量较传统公式减少8％,创面SD-Ag半暴露烤电治疗效果好。
Objective To investigate the characteristics of the burn injury caused by coal mine explosion so as to enhance the cure rate. Methods Analyse the therapeutic result after planned standard treatment of clinical patients and review historical patients. Results ①Coal mine explosion includes two types, i.e. , gas explosion and coal dust explosion. ② This kind of burn is a combined injury with pathologic changes of burns as the Main feature. Mechanical injury is the chief cause of early death. Blast injury mainly damages the lungs. The occurrence of carboxyhemoglobinemia is not often. ③ The amount of fluid infusion in the first 24h in exudation phase is 8% less of the traditional formula. Alka- line balanced salt solution is supplied as electrolyte solution, which can provide 45% of neccessary HCO_3^-for correction of acidosis. ④ No thorough debridement is imposed in the treatment of burn wound. Baking with electric bulb with topical SD-Ag in semi-exposure state can be used. ⑤ Inhalation injury chiefly occurs in upper respiratory tract. The main bacterial species causing complicated lung in- fection are Pseudomonas aeruginosa and Staphylococcus aureus. ⑥ When MSOF occurs, the most fre- quently involved organ and system are the kidney and respiratory system. ⑦The main bacteria causing systemic invasive infection are enteric bacilli and Pseudomonas aeruginosa. Enteric bacilli infection may be enterogenic. The latter infection is chiefly the result of cross infection in hospital. Conclusion The burn caused by coal mine explosion is a combined injury characterized by pathologic changes of burn as the main issue. This kind of burn has two types, i.e. gas-explosion-burn and coal-dust -explosion- burn.
