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目的:探讨氨烧伤合并肺实质损害病人的临床特点和治疗措施。方法:结合相关文献的复习,分析了3例合并严重肺实质损害的氨烧伤病人的治疗经验。结果:病人有如下的临床特点:1早期即有明显的呼吸困难。早期以吸气性呼吸困难为主,后期则以呼气性呼吸困难为显著。2均有不同程度的急性肺水肿表现。3早期气管切开虽有效,但并不能完全缓解呼吸困难。4均有遗留有明显的肺实质损害如肺纤维化,肺脓肿、空洞,支气管扩张,肺顺应性下降等。2例死亡。结论:氨烧伤并发的肺实质损害者预后极为凶险。氧疗、尽早短期大量应用糖皮质激素、早期气管切开、呼吸机辅助呼吸、湿化气道和应用支气管肺泡灌洗技术和抗感染治疗同等重要。
Objective: To investigate the clinical features and treatment of patients with ammonia burn complicated with pulmonary parenchyma. Methods: Based on the review of related literatures, 3 cases of ammonia burn patients with severe pulmonary parenchymal injury were analyzed. Results: The patient had the following clinical features: 1 Early significant dyspnea. Early aspiration of dyspnea, post-expiratory dyspnea was significant. 2 have different degrees of acute pulmonary edema. Early tracheotomy is effective, but does not completely relieve dyspnea. 4 have left behind significant lung parenchymal damage such as pulmonary fibrosis, lung abscess, empty, bronchiectasis, lung compliance and so on. 2 died. Conclusion: The prognosis of patients with lung parenchyma complicated with ammonia burn is very dangerous. Oxygen therapy, as soon as possible a large number of short-term glucocorticoid, early tracheostomy, ventilator-assisted breathing, humidified airway and the application of bronchoalveolar lavage and anti-infective therapy are equally important.