Siah S, Emane A, Bertin-Maghit M
Service de Chirurgie Plastique, Réparatrice et des Brûlés, Hôpital Militaire d'Instruction Mohamed V. Rabat, Maroc.
Centre des Brûlés, Département d'Anesthésie Réanimation, Hôpital Édouard Herriot, Lyon, France.
Ann Burns Fire Disasters. 2016 Sep 30;29(3):189-191.
Blasts can cause specific lesions requiring specialized care. After an explosion, primary blast injury (due to the shock wave), secondary blast injury (due to shrapnel) or tertiary blast injury (due to the victim being displaced by the blast) can occur. Secondary and tertiary blasts are much more frequent than primary blasts and can lead to polytrauma. Burns occur in 5% of cases and are termed quaternary blast lesions, which include lesions not due to the above-mentioned mechanisms. Care of secondary and tertiary blasts does not differ to that for any polytrauma. Primary pulmonary blast worsens the prognosis of more serious patients, but seldom requires specific care. Knowledge of both pathophysiologic and injury characteristics would allow better care of seriously burned-blasted patients. We report a case of primary pulmonary blast in a burn patient.
爆炸伤可导致需要特殊护理的特定损伤。爆炸后，可发生原发性爆炸伤（由冲击波所致）、继发性爆炸伤（由弹片所致）或三级爆炸伤（由爆炸使受害者移位所致）。继发性和三级爆炸伤比原发性爆炸伤更为常见，可导致多发伤。5%的病例会发生烧伤，称为四级爆炸伤，其中包括并非由上述机制导致的损伤。继发性和三级爆炸伤的护理与任何多发伤的护理并无不同。原发性肺爆炸伤会使病情较重患者的预后恶化，但很少需要特殊护理。了解病理生理和损伤特征有助于更好地护理严重烧伤合并爆炸伤的患者。我们报告一例烧伤患者发生原发性肺爆炸伤的病例。
