摘要
本文总结了62例吸入性损伤病人,分为轻、中、重三组.死亡19例,死亡率30.7%。在临床表现中,有一特异体征——喉气管呼吸音高调,这系由喉气管烧伤后,气道水肿狭窄,呼吸音频率变高所致。用听诊器在喉气管部位即可听到。这一检查方法简单易行,可作为诊断吸入性损伤及确定是否做气管切开的一个指征。在治疗中采用了颈部焦痂减张术,缓解了颈部焦痂的缩窄压迫,部分病人避免了气管切开术。本文对人工通气、休克期输液及洗肺等问题进行了探讨。
62 cases with inhalation injury are included in this paper.19 patients died,constitu- ting a mortality of 30.7%. Among the symptoms,there is a characteristic high-pitched laryngotracheal respiratory sound, which is produced by narrowing of the laryngo-tracheal tract due to edema after the injury, It can be heard in the middle of the neck with a stethoscope.It can be regarded both as a diagnostic sign of inhalation injury and an indication for tracheotomy. The pressure exerted by the eschar in the neck can be released by incising the eschar. Tracheotomy can be avoided in some patients after the releasing incisions.Other problmes such as artificial ventilation,liquid resuscitation etc.are also discussed.
