176例气管吸入性损伤气管切开治疗的分析

目的探讨大面积烧伤合并气管吸入性损伤病人气管切开的时机和指征。方法对176例大面积烧伤合并气管吸入性损伤的病人,在伤后不同时机行气管切开与气管烧伤严重程度及预后进行回顾性分析。结果176例大面积烧伤合并气管吸入性损伤病人烧伤后24 h内行气管切开术者128例,其中轻度吸入性损伤67例,气管切开后死亡4例;中度34例,气管切开后死亡9例;重度27例,死亡11例。超过24 h行气管切开术者48例,其中轻度12例,气管切开后死亡8例;中度25例,气管切开后死亡13例;重度11例,死亡9例。结论气管吸入性损伤目前仍是烧伤后死亡的重要原因之一,吸入性损伤宜尽早实行气管切开术,以降低死亡率。

Analysis of treatment with tracheotomy for 176 patients with inhalation injury

Objective To explore the opportunity choice of tracheotomy for patients with extensive burns and inhalation injury.Methods The clinical data,opportunity of tracheotomy and prognosis of 176 patients with extensive burns and inhalation injury were analyzed retrospectively.Results Of all 176 cases,128 cases were treated with tracheotomy within 24 hours after burns,and 48 cases over 24 hours.In the 128 cases,4 cases died in the group of 67 slight inhalation injury,9 died in the group of 34 moderate inhalation injury,and 11 died in the group of 27 heavy inhalation injury.In the 48 cases treated with tracheotomy over 24 hours,8 cases died in the group of 12 slight inhalation injury,13 died in the group of 25 moderate inhalation injury,and 9 died in the group of 11 heavy inhalation injury.Conclusion The inhalation injury is still the major cause of death of the burns.Early tracheotomy plays an important role in decreasing the death rate of burns with inhalation injury.