成批火药爆炸烧伤病人23例救治体会

Experience in treating 23 cases of burn caused by gunpowder explosion

目的:总结MEBT/MEBO成批火药爆炸烧伤临床治疗经验。方法:将我院2002年4月15日收治的一批某村爆竹厂火药爆炸燃烧致伤患者23名,针对其有烧伤、爆震冲击伤、吸入性损伤和化学中毒方面的损伤特点应用MEBT/MEBO和抗休克、保护各内脏器官功能、营养支持、抗感染及对症处理等综合治疗措施,把心肺功能支持与保护放在首位,并贯穿于火药爆炸烧伤治疗的全过程。结果:治愈22例, 治愈率95.7%,死亡1例病死率4.3%;未植皮自行愈合者16例(72.7%),创面植皮者6例(27.3%);全程应用MEBT/MEBO者病情平稳,抗生素应用3～5天,治疗的创面无肉芽增生。非全程(植皮前后)应用MEBT/MEBO者病情不平衡,抗生素应用20～25天,有残余创面轻度肉芽增生高起于创缘。结论:在MEBT/MEBO治疗的基础上采用综合治疗措施是提高成批火药爆炸烧伤病人治愈率的关键。

Objective: To sum up the experience with MEBT/MEBO in treating a group of burn, caused bygunpowder explosion. Method: 23 patients were burned by gunpowder explosion and were complicated with impactinjury, inhalation injury and chemical intoxication. MEBT/MEBO was applied in association with anti-shock, internalorgan function protecting, nutrition support, anti-infection and expectant treatment and other comprehensive measures.Protection of the function of the heart and the lung was put in the first place during the whole course of treatment. Results:22 cases cured, the curative rate was 95.7%. 1 case died, the death rate was 4.3%. 16 cases healed without skin grafting (72.7%), 6 cases healed with skin grafting (27.3%). The condition of the patients treated in the whole course with MEBT/MEBOwas stable. Antibiotic was applied for 3 to 5 days. The condition of the patients who received MEBT/MEBO treatment notin the whole course was unbalance. Antibiotic was applied for 29 to 25 days. Conclusion: MEBT/MEBO in associationwith comprehensive measures can promote the curative rate of the patients burned by gunpowder explosion.