重度吸入性损伤的救治体会

Experience in the management of severe inhalation injury

目的总结30例重度吸入性损伤的治疗经验与失败教训。方法从治愈与死亡病例中回顾与总结重度吸入性损伤的治疗经验。如:诊断明确即行气管切开、吸氧治疗,气道冲洗清除气道分泌物;皮质激素短期用于肺水肿或严重支气管痉挛时,鼓励病人咳嗽、深呼吸、翻身拍背、体位引流等。结果本组30例中治愈14例,治愈率为46.6%,死亡16例.病死率为53.3%。结论抓早、抓好各项治疗措施,重视并发症的防治,可提高此类病人的治愈率。

Objective To summarize our clinical experiences in the treatment of severe inhalation injury accompanying extensive burn.Methods Retrospective analysis of 30 cases of inhalation injury (1980-1996)was done,the cure rate,mortality,effective treatments and lessons of failure were summa- rized.Results As soon as the diagnosis was defined,traeheostomy should be done immediately,followed by oxygen therapy,tracheo-bronchial lavage,aspiration,and clearance of airway secretion.If there was pul- monary edema or severe bronchospasm,cortical hormone was used for a short time,in addition,the patients were encouraged to cough,breathe deeply,and change postures,as well as patted on the back and also po- sitioned to facilitate posture drainage,etc.These measures were effective.In this series,there were thirty cases of severe inhalation injury.Fourteen patients(46.6%)were cured,sixteen patients died(53.3%). The result was basically satisfactory.Conclusion It is possible to increase the cure rate of severe inhala- tion injury,and the treatment should be carried out conscientiously as early as possible,and great attention should be paid to prevent various complications.