中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2013年
3期
281-284
,共4页
李叶扬%汪锦伦%李罡%林伟华%梁岷%黄峻%孙敬恩
李葉颺%汪錦倫%李罡%林偉華%樑岷%黃峻%孫敬恩
리협양%왕금륜%리강%림위화%량민%황준%손경은
烧伤%辐射损伤%电子加速器%并发症
燒傷%輻射損傷%電子加速器%併髮癥
소상%복사손상%전자가속기%병발증
Burns%Radiation injuries%Electron acclerator%Complication
This article reports the treatment of a patient suffered from acute radiation burn covering 41% TBSA,with deep partial-thickness and full-thickness injury,produced by exposure to a large-scale industrial electron accelerator.An open wound began to appear and enlarged gradually 10 weeks after the exposure.Serious wound infection with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa,pneumonia,respiratory failure,systemic inflammatory response syndrome,nephropathy and hypoproteinemia developed successively since 3 weeks after the wound formation.Skin grafts failed to survive,resulting in enlargement of the wound.After being treated with proper measures,including parenteral nutrition,respiratory support with a ventilator,appropriate antibiotics,steroid administration for nephropathy,deep debridement for wounds followed by skin grafting,the patient was cured and discharged after undergoing 15 operations in 500 days.The clinical condition of an extensive acute radiation burn is complicated.We should pay close attention to the changes in functions of organs,and strengthen the therapeutic strategies to support the function of organs to reduce the incidence of systemic complications.The control of the infection and the timely and effective repair of the wound are stiil the key points of the treatment of an extensive local radiation injury.