黄磷烧伤57例治疗体会

CLINICAL EXPERIENCE IN TREATING 57 CASES OF YELLOW PHOSPHORUS BURN

用2～3％硝酸银和等浓度碳酸氢钠溶液早期处理黄磷烧伤创面57例(最大面积51%),均临床治愈,无1例死亡。治疗关健在于及时彻底灭磷火,解磷毒,防止磷被吸收中毒。硝酸银有灭磷火快、解磷毒可靠和使用安全的特点。机理为:2P+7H_2O+8AgNO_3=8Ag↓+8HNO_3+H_3PO_4+H_2PO_3,碳酸氢钠起中和作用。古老治疗药物——硫酸铜易吸收中毒,故用硝酸银取代硫酸铜溶液,更有实用价值。湿润烧伤膏有即刻止痛,抗感染,促进局部血液循环,加快坏死组织液化,促进残余皮肤附件增殖和创面修复能力,使深Ⅱ度创面愈后不留疤痕。

57 cases of yellow phosphorus burn were treated at early stage with 3% silver nitrate and sodium bicarbonate of the same concentration. The burnt area amounted at the most to 51 % of body surface. All the patients were healed. The key to the treatment is to take timely measures to quench the phosphorus fire, to remove the toxic effect of phosphorus and to prevent absorption of phosphorus. Silver nitrate is reliable and safe for use to quench the phosphorus fire and to remove the toxic effect of phosphorus. The mechanism of its action can be explained by the following chem-ical reaction:2P+7H20+8AgN03→8Ag ↓ +8HN03 +H3P04+H3P03 Sodium carbonate is used to neutralize the acids. Copper sulfate which had been used for treat-ing phosphorus burns is easy to be absorbed. Sil-ver nitrate is therefore, superior to copper sulfate for this purpose. Moist burn ointment has instant analgesic and antiinfective effects. It promotes local blood circulation, accelerates the liquefication of necrotic tissue, the proliferation of residual skin appendages and promotes the repair of the wound. For deep second degree burns no scar will be left after healing.