Song Xicheng
Department of Otolaryngology, General Hospital of Zhongyuan Oilfield, Puyang 457001.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2003 Jun;17(6):323-4.
To discuss the time and indication of tracheotomy for patients with inhalation injury.
One hundred and twenty four cases were under tracheotomy in 1-24 hours after burn in which 85 were gentle (11 died after operation), 22 moderate (9 died post-operation), 17 severe (11 died post-operation), 24 hours later there were 51 cases were operated in which the gentle 12 (8 died after operation), the moderate 34 (15 died post-operation) and the severe 5 (5 died post-operation). There were 5 patients had died before tracheotomy. There were 21 cases with cervical annular and deminannular eschar, 90 cases with severe burn in head and face, and 32 cases with fish mouths, 37 cases with blood serum bleeding in mouth and nose cavities.
The crisis of larynx obstruction is the most important factor of causing death, and the earlier tracheotomy in patients with inhalation injury can reduce the incidence of larynx obstruction crisis and mortality.
探讨吸入性损伤患者气管切开的时机及适应证。
124例患者于烧伤后1 - 24小时内行气管切开术,其中轻度85例(术后死亡11例),中度22例(术后死亡9例),重度17例(术后死亡11例);24小时后行气管切开术51例,其中轻度12例(术后死亡8例),中度34例(术后死亡15例),重度5例(术后死亡5例)。5例患者在气管切开术前死亡。有21例患者存在颈部环形及半环形焦痂,90例患者头面部严重烧伤,32例患者出现“鱼口状”创面,37例患者口鼻腔有血清样渗血。
喉梗阻危象是导致死亡的最重要因素,吸入性损伤患者早期行气管切开可降低喉梗阻危象的发生率及死亡率。