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气道烧伤的临床表现、治疗及预后因素的综合综述

Comprehensive review of clinical presentation, treatment, and prognostic factors of airway burns.

作者信息

Giurgiu Rares-Adrian, Bordeanu-Diaconescu Eliza-Maria, Grosu-Bularda Andreea, Frunza Adrian, Grama Sabina, Dumitru Cătălina-Ştefania, Costache Raducu-Andrei, Cristescu Carina-Ioana, Lascar Ioan, Hariga Cristian-Sorin

机构信息

Department 11, Discipline Plastic and Reconstructive Surgery, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.

Burn Centre, Emergency Clinical Hospital of Bucharest, Bucharest, Romania.

出版信息

J Med Life. 2025 May;18(5):405-410. doi: 10.25122/jml-2025-0081.

Abstract

Inhalation injury is a major contributor to poor outcomes in burn patients, increasing the risk of respiratory complications, prolonged hospitalization, and mortality. This review summarizes current knowledge on the pathophysiology, diagnosis, and management of airway burns, based on clinical studies and guidelines. Injuries may be supraglottic, subglottic, or systemic, each leading to inflammation, airway obstruction, and impaired gas exchange. Carbon monoxide and cyanide toxicity further worsen systemic hypoxia. Diagnosis depends on clinical signs, imaging, and bronchoscopy, which remains the gold standard. Treatment involves airway stabilization, ventilatory support, inhaled therapies, and antidotes for toxic exposure. Prognosis is affected by burn extent, systemic response, and comorbidities such as substance abuse. Survivors often experience long-term pulmonary dysfunction, emphasizing the need for early, multidisciplinary intervention.

摘要

吸入性损伤是烧伤患者预后不良的主要因素,增加了呼吸并发症、住院时间延长和死亡率的风险。本综述基于临床研究和指南,总结了目前关于气道烧伤的病理生理学、诊断和管理的知识。损伤可能发生在声门上、声门下或全身性,每种情况都会导致炎症、气道阻塞和气体交换受损。一氧化碳和氰化物中毒会进一步加重全身缺氧。诊断取决于临床体征、影像学检查和支气管镜检查,支气管镜检查仍是金标准。治疗包括气道稳定、通气支持、吸入治疗以及针对中毒暴露的解毒剂。预后受烧伤程度、全身反应和药物滥用等合并症的影响。幸存者常经历长期肺功能障碍,这凸显了早期多学科干预的必要性。

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