摘要
目的:探讨大面积烧伤合并有吸入性损伤时气管切开的时机与指征。方法:对180例大面积烧伤(其中石油天然气烧伤144例,轻质油烧伤26例,热蒸汽烧伤10例),合并有呼吸道吸入性损伤的病人,在烧伤后进行气管切开的依据、必要性、时机、指征及手术要点进行总结。结果:180例大面积烧伤合并有呼吸道吸入性损伤病人,烧伤后1-24小时进行气管开术124例,其中轻度85例(气管切开后死亡4例),中度22例(气管切开后死亡9例),重度17例(气管切开后死亡11例),超过24小时后进行气管切开术51例,其中轻度12例(气管切开后死亡8例),中度34例(气管切开后死亡15例),重度5例(气管切开后死亡5例)。有5例重度吸入性损伤未及气管切开即死亡。气管切开时颈部有环状或半环状焦痂21例,伴头面部严重烧伤90例,口呈鱼嘴状者32例,口鼻内大量血清性渗出者37例。结论:吸入性损伤时喉梗阻危象的发生是引起烧伤病人死亡的重要原因,强调大面积烧伤伴有呼吸道吸入性损伤时,应在烧伤后早期及时进行气管切开术,可以降低病人喉梗阻危象的发生率和死亡率。
Objective:To explore the opportunity choice of tracheotomy for patinets with extensive burns and draw trachea injure. Methods:One hundred and eighty patients with extensive burns and draw trachea injure were treated from July 1983 to December 2001. The opportunity of tracheotomy was observed and retrospectively analyzed. Results:Among 180 patients, 124 were traheotomy after 1 to 24 hours of burns,51 tracheotomy over 24 hours,and 5 were not tracheotomy because heavy degree burns died not long after. In the 124 cases of 1-24 hours tracheotomy ,4 cases died after tracheotomy in the group of 85 slight degree burns, 11 cases died after tracheotomy in group of 17 heavy degree burns. In the 51 cases of over 24 hours tracheotomy ,8 died after tracheotomy in the group of 12 slight degree burns, 15 died after tracheotomy in the group of 34 mild degree burns,and 5 died after tracheotomy in the group of 5 heavy degree burns. Conclusion:The laryngeal abstracts of draw trachea injure is major cause of die for patients with extensive burns. Early tracheotomy is a important role in the decrease die rate for the patients with extensive hums.
出处
《耳鼻咽喉（头颈外科）》
2003年第1期17-19,共3页
Chinese Arch Otolaryngology-Head Neck Surg
关键词
气管切开
气管疾病
烧伤
(Tracheotomy) (Tracheal diseases) (Burns)
