气管切开术在治疗头面颈部烧伤中的临床意义

Clinical significance of tracheotomy in treating head - neck burns

目的探讨头面颈部烧伤病人行气管切开术的适应证、手术时机及有关注意事项。 方法对36例头面颈部烧伤行气管切开术的病人进行回顾性总结。结果 36例病人均在伤后12-72小时内行气管切开术,解除了上呼吸道梗阻,清除了下呼吸道分泌物,改善了缺氧状况,提高了严重烧伤病人的治愈率。本组治愈31例(86.1％),死亡5例(13.9％)。结论对头面颈部烧伤尤其是吸入性损伤病人,应尽早行气管切开术,时间选择在伤后12小时内为宜,拔管选择在手术后2周左右为宜。

Objective To explore the indications, timing and related issues of tracheotomy in head-neck burn patients. Methods Thirty-six cases, which underwent tracheotomies after head-neck burns were analyzed retrospectively. Results Tracheotomy performed on all 36 cases within 12-72 hours after burns. It showed that the procedure improved cure rate by remove upper airway blocking, clean up lower airway secretions, and alleviate hypoxia. In the 36 cases, 31 cases cured (86.1 %) and 5 cases died (13.9 %). Conclusion Tracheotomy in early stage could be a good treatment for head-neck burns, especially for extensive injury. Good timing to do tracheotomy is within 12 hours after burns. Decannulation should be done after 2 weeks. Time chooses should be in 12 hours and pull out the tracheal tube after 2 weeks.