特大面积烧伤患者麻醉及围术期并发症探讨(附15例报告)

Investigation of anaesthetic and operative period complication of severe burnt patients

目的 探讨特大面积烧伤患者围术期病情发展特点及麻醉管理要点。方法 回顾性分析近 1年来烧伤面积在 80 %以上的 15例重症烧伤患者 ,研究其病程发展特点 ,麻醉手术过程 ,术后转归及死亡病因分析。结果 15例特大面积烧伤患者中 ,治愈 12例 ,死亡 3例。围术期主要并发症有 :休克、重度贫血及血小板减少、早期肺水肿及肺部感染、气道粘膜脱落、ARDS (呼吸窘迫综合征 )、心功能衰竭。结论 肺及血液系统的变化是早期烧伤后累及伤害的主要器官。围术期治疗以及麻醉管理应重视呼吸功能支持和血液保护 ,加强补液的监控 ,防止术后肺水肿。

Objective To investigate the perioperation characteristic and the points of anaesthetic management of severe burnt patients.Methods To analyze respectively severe burnt patients whose surface was burned more than 80%,and to study the characteristic of burn development,process of anaesthesia and operation, the dead reason after operation.Results Among 15 cases,12 ones were cured,three dead.Complications of perioperation were shock,severe blood cell less,pulmonary edema,et al.Conclusion The significant pathology changes of severe burning patients were blood system,pulmonary complication. During treatment and anaesthetic management,blood protection and respiratory maintain should be paid attention.We should understand the points of in development,prevent complications from occurring. [