吸入性损伤的临床分析

A clinical analysis of the cases of inhalation injury

目的:回顾我科1996年～2001年6年中收治1058例烧伤患者,分析吸入性损伤病例,总结临床治疗的经验.方法:采用统计学的方法,将病例按烧伤面积分成五个组别,对吸入性损伤的发生率、病死率与烧伤面积的关系分别进行分析.结果:吸入性损伤的发生率随烧伤面积的增大而上升,吸入性损伤的病死率改变与烧伤面积的变化不明显,烧伤合并吸入性损伤的病死率明显高于单纯皮肤烧伤患者的病死率,各烧伤面积组病死率随烧伤面积的增加而上升.结论:近年来我科吸入性损伤的救治水平有了明显的提高,通过伤后吸入高浓度的氧甚至纯氧;预防性气管切开;伤后早期进行小量反复的气道灌洗;早期应用带湿化的PEEP机械性通气;调整休克期补液量和防治感染等治疗,使吸入性损伤的病死率大幅度降低.

Objective: To make a retrospective analysis of 1058 cases of inhalation injury treated in ourdepartment in the period from 1996 to 2001. and to sum up clinical experience. Method: According statistical methods,the cases were divided into 5 groups, and the correlation between the incidence of inhalation injury, death rate and burnarea was analyzed. Results: The incidence of inhalation injury increased with increasing burn area, the death rate ofinhalation injury had no obvious correlation with burn area, the death rate of burn increased with increase in burn area.Conclusion: Our treatment level has been greatly heightened in these years, since the application of inhalation of highconcentration of oxygen and pure oxygen, preventive tracheotomy, repeated air passage lavation in small amount at earlystage post injury, early application of PEEP mechanical ventilation, adjusting the volume of infusion at shock stage andtaking measures for injury has been greatly decreased.