小儿烧伤后早期误吸13例临床分析

Cases and Control Measures of Early Aspiration in Pediatric Burn Victims

目的 探讨小儿烧伤后早期误吸发生的原因及其防治措施。方法 回顾分析我科 1 993年月 1月— 2 0 0 2年 1 1月小儿烧伤 3 891例中发生误吸患儿 1 3例的发病原因 ,临床特点 ,治疗及预后情况。结果 小儿误吸多为婴幼儿年龄段幼儿 ,多发生伤后 2 4h以内 ,早期给予镇静剂 ,未及时输液 ,大量饮水或母乳是其主要诱因 ,主要表现为呼吸道梗阻。结论 小儿烧伤后早期 ,应避免大量饮水和母乳 ,避免给予镇静剂。及时发现 ,及早诊断 ,保持呼吸道通畅 ,是抢救成功的关键。对于误吸时间长 ,严重低氧血症 ,伴有心、肺、脑损害者 ,应及时行气管切开 ,PEEP正压通气。

Objective To discuss the causes and control measures of early aspiration in pediatric burn victims. Methods From jan. 1993 to nov.2002 3 891 cases of pediatric burn were treated in our department. And 13 causes of them accompanied with aspiration.their causes clinical characteristic,treatments and prognosis were analysed.Results Early aspiration mainly occurred in badies and infants,and mostly took place within 24 hours after burn.Using thalidomide,delayed resuscitation and plenty of water or milk intake were the inducements of aspiration.Its main cilical behavior was respiratory obstruction.Conclusion Thalidomide injection and plenty of water or milk intake should be avoided in early stage of burn.Discovering and diagnosis as soon as possible and keeping airway free are the key points of a successful emergency treatment.Tracheotomy and PEEP ventilation should be carried out immediately on the patients with a long time of aspiration,severe hypoxemia,heart failure,pulmonary,or brain damage.