Zhao Ruo-Mei, Li Yi, Chao Sheng-Wu, Wang Hong-Jin
The Graduate School Of Qinghai University, Xining 810016, Qinghai Province, China.
Department of Burns and plastic Surgery, Affiliated Hospital of Qinghai University, Xining 810001, Qinghai Province, China.
World J Clin Cases. 2020 Apr 6;8(7):1337-1342. doi: 10.12998/wjcc.v8.i7.1337.
The aim of this study was to report a case of a patient who suffered from severe concentrated sulfuric acid burns while working at high altitude. This patient recovered after systemic treatment. We also provide a literature review for a better understanding of the disease.
A 30-year-old male, who was working in a local chemical plant in Xining (the Qinghai provincial capital, China) at an altitude of 2261 m, suffered from burns 85% TBSA (III° 70%TBSA, deep II° 15%TBSA) after a tank containing 80% concentration of sulfuric acid exploded. The patient immediately received a series of first aid treatments, as well as rigorous wound managements after admission, which included protection for the whole body and organs, prevention and treatment of eye burns, and the appropriate oxygen therapy. After 65 d of treatment, the burn wounds had completely healed, and the patient was transferred to another specialized hospital for further eye treatment. The first aid before admission and the emergency treatment of wounds following admission were appropriate. No severe complications of sepsis, severe renal insufficiency, septic costal chondritis, corneal perforation or other burns occurred during the treatment.
The main causes of concentrated sulfuric acid burns consisted of accidental burns at work, accidents in the outside, factitious injuries and improper laboratory operations. The clinical manifestations were mostly deep II° and III° burns, with a formation of brown-black, leather-like eschar on the wound surface and locally embolized dendrite-like vessels. The clear cause of the injury and typical clinical manifestations in this case made it easy to diagnosis. However, adult cases with severe concentrated sulfuric acid burns in high altitude areas are rare, so the successful treatment of this case is of great significance.
本研究旨在报告1例在高海拔地区工作时遭受浓硫酸重度烧伤的患者。该患者经全身治疗后康复。我们还进行了文献综述以更好地了解该疾病。
一名30岁男性，在中国青海省省会西宁海拔2261米的当地一家化工厂工作，在一个装有80%浓度硫酸的储罐爆炸后，全身85%体表面积烧伤（Ⅲ度70%体表面积，深Ⅱ度15%体表面积）。患者立即接受了一系列急救治疗，入院后进行了严格的创面处理，包括全身及器官保护、眼烧伤防治及适当的氧疗。经过65天治疗，烧伤创面完全愈合，患者转至另一家专科医院进行进一步的眼部治疗。入院前急救及入院后创面急诊处理得当。治疗期间未发生脓毒症、严重肾功能不全、化脓性肋软骨炎、角膜穿孔或其他烧伤等严重并发症。
浓硫酸烧伤的主要原因包括工作时意外烧伤、户外事故、人为伤害及实验室操作不当。临床表现多为深Ⅱ度和Ⅲ度烧伤，创面形成棕黑色皮革样焦痂，局部有树枝状栓塞血管。该病例损伤原因明确，临床表现典型，易于诊断。然而，高海拔地区成人重度浓硫酸烧伤病例罕见，因此该病例的成功治疗具有重要意义。
