临床与病理杂志
臨床與病理雜誌
림상여병리잡지
International Journal of Pathology and Clinical Medicine
2015年
5期
783-786
,共4页
头颈部大面积烧伤%气管切开%时机%指征
頭頸部大麵積燒傷%氣管切開%時機%指徵
두경부대면적소상%기관절개%시궤%지정
large area burns%tracheotomy%timing%indications
目的：大面积烧伤患者，特别是头颈部烧伤患者气管切开的时机以及气管切开指征需要进一步研究和探讨。方法：选择头颈部大面积烧伤患者，根据患者气管切开情况分为预防性和紧急性气管切开。对比两组患者气管切开手术时间以及手术指征。结果：预防性气管切开有57例，紧急气管切开有46例。其中预防性气管切开中度和重度吸入性损伤有41例，占71.93%；紧急气管切开中重度吸入性损伤患者有24例，占52.17%。预防性气管切开的手术时间是(5.51±1.28) h，紧急气管切开手术时间是(24.80±4.67) h。结论：中重度头颈部大面积烧伤患者要尽早进行预防性气管切开。没有进行预防性气管切开的患者发生气道损伤后24 h是气道梗阻的高发时间，应该要密切患者是否出现如呼吸道有大量粘稠分泌物，口鼻内有大量血清样渗出以及吸氧治疗，PaO2升高不明显，“鱼嘴状”口唇以及颈部焦痂形成等应该考虑为患者进行气管切开手术治疗。
目的：大麵積燒傷患者，特彆是頭頸部燒傷患者氣管切開的時機以及氣管切開指徵需要進一步研究和探討。方法：選擇頭頸部大麵積燒傷患者，根據患者氣管切開情況分為預防性和緊急性氣管切開。對比兩組患者氣管切開手術時間以及手術指徵。結果：預防性氣管切開有57例，緊急氣管切開有46例。其中預防性氣管切開中度和重度吸入性損傷有41例，佔71.93%；緊急氣管切開中重度吸入性損傷患者有24例，佔52.17%。預防性氣管切開的手術時間是(5.51±1.28) h，緊急氣管切開手術時間是(24.80±4.67) h。結論：中重度頭頸部大麵積燒傷患者要儘早進行預防性氣管切開。沒有進行預防性氣管切開的患者髮生氣道損傷後24 h是氣道梗阻的高髮時間，應該要密切患者是否齣現如呼吸道有大量粘稠分泌物，口鼻內有大量血清樣滲齣以及吸氧治療，PaO2升高不明顯，“魚嘴狀”口脣以及頸部焦痂形成等應該攷慮為患者進行氣管切開手術治療。
목적：대면적소상환자，특별시두경부소상환자기관절개적시궤이급기관절개지정수요진일보연구화탐토。방법：선택두경부대면적소상환자，근거환자기관절개정황분위예방성화긴급성기관절개。대비량조환자기관절개수술시간이급수술지정。결과：예방성기관절개유57례，긴급기관절개유46례。기중예방성기관절개중도화중도흡입성손상유41례，점71.93%；긴급기관절개중중도흡입성손상환자유24례，점52.17%。예방성기관절개적수술시간시(5.51±1.28) h，긴급기관절개수술시간시(24.80±4.67) h。결론：중중도두경부대면적소상환자요진조진행예방성기관절개。몰유진행예방성기관절개적환자발생기도손상후24 h시기도경조적고발시간，응해요밀절환자시부출현여호흡도유대량점주분비물，구비내유대량혈청양삼출이급흡양치료，PaO2승고불명현，“어취상”구진이급경부초가형성등응해고필위환자진행기관절개수술치료。
Objective:Review our clinical experiences in the treatment of large area burn. Discuss the timing and the indications of tracheotomy for the large area burn patients. Methods:By different tracheotomy timing the large area burn patients were divided into preventive and emergency tracheotomy. hTe tracheotomy operation time and the operation indications of two group patients were compared. Results:hTe preventive tracheotomy had 57 cases, while the emergency tracheotomy had 46 cases. hTe preventive tracheotomy for moderate and severe inhalation injury were 41 cases, 71.93%;emergency tracheotomy group with severe inhalation injury were 24 cases, 52.17%. The timing of preventive tracheotomy was (5.51+1.28) h, while the emergency tracheotomy operation time is (24.80+4.67) h. Conclusion:Severe large area burn patients should take the preventive tracheotomy. It’s high possibility that 24 h atfer injury the large area burn patients would have the airway obstruction. hTe indications for the tracheotomy are:a large number of respiratory sticky secretions, nose with large number of serum exudation and although during the oxygen therapy, the PaO2 of the patient was still not elevated. And the“ifsh mouth”lips and neck Escher formation also are the important operation indications for tracheotomy.
