黄磷烧伤75例治疗体会

Treatment Experience of 75 Cases with Yellow Phosphorus Burn

目的探讨黄磷烧伤后的有效处理办法和注意事项。方法选取2007年1月至2009年12月昆明医学院第二附属医院收治的75例患者,对其治疗过程进行观察和分析。浅Ⅱ度患者重点是通过冲洗,创面换药,促进创面愈合。深Ⅱ度、Ⅲ度烧伤患者早期给予抗休克,创面换药,抗感染等治疗,重点是早期切痂,一期手术植皮。结果 32例浅Ⅱ度患者未接受手术治疗,经创面换药后创面愈合。其余43例手术治疗,其中8例患者切痂后二期植皮。共治愈74例,其中最大烧伤面积86%TBSA、Ⅲ度65%TBSA。因急性肾功能不全并发多器官功能衰竭而死亡1例。结论黄磷烧伤不仅存在单纯热力的烧伤,而且还存在磷酸对创面及周围组织的继续腐蚀,不断加深。早期重视创面处理、早期彻底切痂、重视并发症的处理是治疗的关健。

Objective To explore the effective treatment and considerations after yellow phosphorus burn.Methods To select 75 patients in the Second Affiliated Hospital of Kunming Medical College from January 2007 to December 2009,to observe and analyze their treatment.The emphasis of patients with superficial Ⅱ degree was to promote the wound healing by washing,wound dressing.The patients with deep Ⅱ,Ⅲ degree were given with anti-shock,wound dressing,anti-infection therapy,the emphasis was to remove scab in early stage and skin grafting in the first phase surgery.Results 32 patients with superficial Ⅱ degree did not receive surgical treatment,the wound was healed by wound dressing.Among the remaining 43 cases of surgical treatment,8 patients had phase Ⅱ skin grafting after escharectomy.Among 74 cases cured,there had the largest burn area of 86% TBSA,Ⅲ degree 65% TBSA.Due to acute renal failure and multiple organ failure,one case died.Conclusion The yellow phosphorus burn not only exist simple thermal burns,but also exist phosphoric acid to corrode the wound and surrounding tissues.The treatment key was to attention the wound management,complete escharectomy early,pay attention to complications.