Robb Bruce W, Hungness Eric S, Hershko Dan D, Warden Glenn D, Kagan Richard J
Department of Surgery, University of Cincinnati, The University Hospital, Cincinnati, Ohio 45267-0558, USA.
J Burn Care Rehabil. 2003 Nov-Dec;24(6):403-6; discussion 402. doi: 10.1097/01.BCR.0000096275.27946.68.
The use of home oxygen therapy has become increasingly commonplace and is frequently prescribed by medical specialists. In this study, we have identified a generally unexpected risk of home oxygen therapy. We performed a retrospective review of 3673 consecutive patients treated at our adult burn center over a 10-year period from 1992 to 2001. We identified 27 patients with burns directly attributable to oxygen therapy and also noted an increased incidence of these injuries over the study period. The average age of the patients was 68.1 +/- 9.2 years (range, 40-82 years). Twenty-three were using oxygen at home, three in nursing homes, and one was an inpatient in an acute care facility. Twenty-five patients (93%) were receiving oxygen therapy for the diagnosis of chronic obstructive pulmonary disease. Twenty-four patients (89%) were smoking while using oxygen, two were lighting pilot lights, and one was lighting his wife's cigarette. Four patients (15%) sustained burns greater than 10% TBSA. Seventeen patients (63%) had only partial thickness burns. Thirteen patients (48%) required admission for treatment of their burn injuries. The average length of stay for those admitted was 4.4 days. The average hospital charge for admitted patients was US dollars 8055. There were four deaths (15%), all of which were correlated only with the extent of injury. Although intuitively obvious to most health care professionals, not all patients understand that oxygen therapy and cigarettes or open flame can result in a significant injury. Although some practitioners have advocated not prescribing home oxygen for those who continue to smoke, an alternative means of reducing the incidence of this preventable complication appears warranted. Prevention efforts should focus on the counseling of patients and their caregivers as well as educating primary care physicians, nurses, and home health providers as to the dangers of oxygen use.
家庭氧疗的使用已变得越来越普遍，并且经常由医学专家开具处方。在本研究中，我们发现了家庭氧疗一种普遍未被预料到的风险。我们对1992年至2001年这10年间在我们成人烧伤中心连续接受治疗的3673例患者进行了回顾性研究。我们确定了27例直接归因于氧疗的烧伤患者，并且还注意到在研究期间这些损伤的发生率有所增加。患者的平均年龄为68.1±9.2岁（范围为40 - 82岁）。23例在家中使用氧气，3例在疗养院使用，1例是急性护理机构的住院患者。25例患者（93%）因慢性阻塞性肺疾病的诊断而接受氧疗。24例患者（89%）在使用氧气时吸烟，2例在点燃引火物，1例在为妻子点烟。4例患者（15%）烧伤面积超过总体表面积的10%。17例患者（63%）仅有部分厚度烧伤。13例患者（48%）因烧伤损伤需要住院治疗。入院患者的平均住院时间为4.4天。入院患者的平均住院费用为8055美元。有4例死亡（15%），所有死亡均仅与损伤程度相关。尽管对大多数医疗保健专业人员来说直观上很明显，但并非所有患者都明白氧疗与香烟或明火会导致严重损伤。尽管一些从业者主张不为继续吸烟的患者开具家庭氧疗处方，但似乎有必要采取另一种方法来降低这种可预防并发症的发生率。预防措施应侧重于对患者及其护理人员的咨询，以及对初级保健医生、护士和家庭健康服务提供者进行关于使用氧气的危险的教育。
