烧伤合并吸入性损伤病人的肺功能检测

报道了36例烧伤病人的肺功能检测，结果：（1）中等面积，大面积烧伤和体表烧伤合并吸入性损伤患者用力肺活量（FVC），第1秒时间肺活量（FEV1.0，呼出50%肺活量时的呼气流速（FEF50%），呼出75%用力肺活量时的呼气流速（FEF75%）降低，于伤后50h降至最低值；（2）中等烧伤面积组伤后10d时FVC，FEV1.0，FEF50%，FEF75%有所回升；至伤后30d恢复正常；（3）大面积烧伤和体表烧伤合并吸入性损伤组伤后50h和10d均明显降低；伤后30d有所升高，除大面积烧伤组FVC伤后30d时FVC已恢复正常外，均未达到正常范围；（4）体表烧伤合并吸入性损伤组的各时点所观察的肺功能参数下降较大面积烧伤组更为明显，采用微型肺量计检测对监护烧伤病人肺功能具有一定临床意义。     

特重烧伤复合肺爆震伤的临床观察和治疗

目的 探讨特重度烧伤伴肺爆震伤的诊断和治疗方法。方法 总结和分析一批16例特重烧伤伴肺爆震伤患者的临床资料。结果 16名伤员在伤后7~10d均出现肺爆震伤表现,X线表现多样,5例并发急性呼吸窘迫综合征,全部并发肺部感染。14例治愈,2例死亡,所有伤员创面愈合良好。结论 本组伤员肺爆震伤的临床表现迟,症状重,持续时间长;肺部感染与胸腔积液发生率高;胸部X线表现多样,与肺部感染不易鉴别。治疗上应重点防治多器官功能不全,调整胶体液和晶体液的比例,应用低潮气量肺保护性通气结合肺复张策略,加强对呼吸机相关性肺炎的防治,控制肺部及创面感染,改善微循环,保护重要脏器功能及加强营养支持都是有效的治疗方法。     

特重烧伤复合肺爆震伤的临床观察和治疗

目的探讨特重度烧伤伴肺爆震伤的诊断和治疗方法.方法总结和分析一批16例特重烧伤伴肺爆震伤患者的临床资料.结果16名伤员在伤后7～10 d均出现肺爆震伤表现,X线表现多样,5例并发急性呼吸窘迫综合征,全部并发肺部感染.14例治愈,2例死亡,所有伤员创面愈合良好.结论本组伤员肺爆震伤的临床表现迟,症状重,持续时间长;肺部感染与胸腔积液发生率高;胸部X线表现多样,与肺部感染不易鉴别.治疗上应重点防治多器官功能不全,调整胶体液和晶体液的比例,应用低潮气量肺保护性通气结合肺复张策略,加强对呼吸机相关性肺炎的防治,控制肺部及创面感染,改善微循环,保护重要脏器功能及加强营养支持都是有效的治疗方法.     

化学性眼灼伤的急救处理与护理

目的：探讨对化学性眼灼伤患者进行急救处理与护理的临床疗效。方法回顾性分析我院89例化学性眼灼伤患者,对其施以标准化急救处理和心理、生活、饮食、预防并发症等护理干预。结果患者出院时视力较入院时得到提升,差异有统计学意义。结论及时有效的急救处理与精心治护有助于改善化学性眼灼伤患者的预后,并能减少并发症的发生。     

176例化学烧伤的治疗

目的 :总结治疗 176例化学烧伤的临床经验 ,对化学烧伤治疗的基本原则进行探讨。方法 :回顾性分析我院1985年 1月～ 1997年 7月收治的 176例化学烧伤的临床资料。结果 :176例中 ,77.60 %的烧伤与工作中的意外事故有关 ,造成烧伤的化学物质有 14种。经治疗痊愈 171例 ,死亡 5例。结论 :化学烧伤的治疗要强调伤后尽快清除创面污物 ,用大量清水冲洗 ,适当使用中和剂 ,防治全身中毒和吸入性损伤     

Smoke inhalation

Two cases of smoke inhalation injury are reported with a brief review of the pertinent literature. The frequency of occurrence, the mortality rate, the clinical course of this common event are discussed with emphasis on the following facts: 1) Pulmonary injury is often associated with skin burns and, conversely, skin burns, particularly when severe, are accompanied by significant effects on pulmonary function; 2) Domestic fires, which account for most of these casualties, may involve complex exposure to a variety of aggressive agents (CO, HCN, NOx, etc.), causing systemic effects; 3) The clinical course of the most severe occurrences characteristically consists of three phases, namely acute pulmonary insufficiency, pulmonary edema and bronchopneumonia, in sequence; 4) The mortality rates of these clinical phases range at or about 50 per cent; 5) Significant laryngeal edema and even pulmonary edema may follow an interval of several hours, during which both subjective and objective evidence of injury may be minimal or unnoticed; and 6) The determination of carboxyhemoglobin levels often helps in gauging the severity of the exposure and related effects of either immediate or delayed appearance.     

Caustic burns from contact with wet cement

Cement is a widely used mixture in construction. A corrosive alkali, calcium hydroxide, is liberated as water is added to the lime present in the cement mixture. Skin contact for prolonged periods produces deep chemical burns with thick eschar formation. Five cases of chemical burns to the lower extremities following contact with the cement mixture are presented. When full-thickness burns were present, long periods of hospitalization were necessary for eschar separation prior to skin grafting. Early excision of full-thickness caustic burns with immediate skin grafting diminished the length of hospitalization and returned the patient to work sooner.     

含药辐照异种角膜在眼化学性烧伤中的应用

应用含药辐照异种角膜治疗眼化学性烧伤１５ 例（２５ 眼），结果治愈１６ 眼，未发生角膜穿孔，有效率达６４％ ，为眼化学性烧伤提供了一种新的治疗途径。     

新鲜羊膜移植在眼化学伤及角膜溃疡的临床研究

目的探讨羊膜移植治疗严重的曩化学伤及角膜溃疡的临床应用及其疗效。方法选择本院急性眼化学伤13例（15只眼）,角膜溃疡7例（7只眼）临床连续住院患者,分别行单纯新鲜羊膜移植术19例（21只眼）,羊膜移植联合板层角膜移植术1例（1只眼）。通过观察患者术后的角结膜情况、视功能等来评价疗效,术后随访观察6-12个月。结果所有病例术后临床上均未见新鲜羊膜植片志性排斥反应。严重急性眼化学伤的15只眼中,未见角膜新生血管,角结膜无进行性溶解和穿孔,角膜溃疡7只眼术后未见复发。视力有不同程度的提高。结论新鲜羊膜移植能减少新生血管,抑制纤堆组织增生,减轻炎性反应,对治疗急性眼化学伤及角膜溃疡安全有效。     

A Clinical Analysis of 1255 Children with Burn Injuries

In a twenty-five year period(1958-1983),there were altogether 4651burn cases admitted to this institute,of whom 1255 were children(26.95%).Themortality rate of this series of young victims was 4.7%(59 cases).The causes ofdeath were septicemia(30 cases),shock(17),cerebral edema and cerebral hernia(4),acute renal failure(4),severe burn wound sepsis(2),and pulmonarycomplications resulting from severe inhalation burns(2).Since the mortality and the incidence of shock and septicemia were closelyrelated to the extensiveness of the burn injuries,a new classification of burninjuries in children is suggested as follows:1.Mild burns:The affected area is less than 10% TBSA.2.Moderate burns:10-29% TBSA is injured.3.Severe burns:30-49% TBSA is injured.4.Extremely severe burns:More than 50% TBSA is injured.     

化学热液烫伤合并中毒的诊治

目的探讨化学热液烫伤的特点和治疗措施.方法对67例化学热液烫伤患者的致伤原因、致伤剂的化学成分、创面处理及解毒方法进行了分析和研究.特别是对含多种成分的化学热液烫伤应采取的正确方法进行了讨论.结果通过采用解毒、针对性的创面处理、早期切痂和植皮,67例患者全部治愈.结论对多种成分的化学热液烫伤,诊断和治疗上应优先解决中毒问题,创面处理应针对数量最多、毒性最强物质,早期切痂植皮效果良好.     

ROLES OF SOME INFLAMMATORY MEDIATORS IN THE PATHOGENESIS OF EARLY PULMONARY EDEMA IN STEAM RESPIRATORY BURNS

The roles of some inflammatory mediators in the pathogenesis of early pulmonary edema by steam inhalation were studied. The experiments were carried out on 36 healthy dogs. The results showed that the pathogenesis of pulmonary edema in severe steam respiratory burns is mainly as follows: direct action by heat leads to organic lesions of pulmonary capillaries and the changes of some inflammatary mediators, i.e., complements, anaphylatoxin, his- tamine, PGFi and cAMP, in the left ventricular blood and the lung tissues resulting in increase of per- meability of pulmonary capillaries.     

眼化学烧伤的临床救治及护理分析

目的对眼化学烧伤的临床救治及采取的护理措施进行分析探讨。方法选取40例眼化学烧伤病人,对其进行有效的临床救治并采取特殊积极的临床护理。结果 40例患者（72只眼）经过临床治疗及特殊的精细护理后,有10只眼仍有眼睑外翻症状,6只眼有角膜增生,2只眼有白色浑浊现象。40例患者治疗前比较,差异有统计学意义（P〈0.05）。40例患者（72只眼）经过临床治疗及特殊的精细护理后,患者的37只眼治愈;26只眼患者有效;9只眼患者无效。总有效率为87.5%。结论及时治疗,精细护理,对眼化学烧伤的患者有很好的临床疗效,临床效果显著。     

Nd:YAG激光与左旋咪唑治疗慢性糜烂型口腔扁平苔藓临床比较

目的 观察Nd：YAG激光与左旋咪唑对慢性糜烂型口腔扁平苔藓的治疗效果。方法 对59例口腔扁平苔藓患者按随机数字表随机分为两组,A组29例,采取口服左旋咪唑治疗;B组30例采用Nd：YAG激光治疗,随访1年,对其疗效评价。结果 经统计学处理,两组显效率差异有统计学意义（P〈0．05）,有效率差异无统计学意义（P〉0．05）。结论 Nd：YAG激光治疗糜烂型口腔扁平苔藓疗效优于采取左旋咪唑治疗,为临床治疗口腔扁平苔藓拓宽了途径。     

活胃方合穴位埋线治疗慢性糜烂性胃炎临床研究

目的:评价活胃方合穴位埋线治疗慢性糜烂性胃炎的疗效。方法:将60例患者随机分成两组,治疗组30例,对照组30例。治疗组以活胃方合穴位埋线治疗;对照组给予西药治疗。结果:治疗组的症状积分比和糜烂病灶愈合的总有效率均优于对照组(P<0.05)。结论:活胃方合穴位埋线治疗慢性糜烂性胃炎的疗效理想,值得进一步研究与推广。     

HPLC-PDA法检测正天丸和正天胶囊中6种非法添加色素

目的 观察昆明山海棠口腔膜对糜烂型口腔扁平苔藓的临床疗效。方法 166例糜烂型口腔扁平苔藓患者随机分为治疗组（84例）和对照组（82例）,治疗组给予昆明山海棠口腔膜每日2次,治疗4周;对照组给予醋酸地塞米松粘贴片每日2次,治疗4周。治疗结束时用客观指标和主观指标分别评价疗效。客观指标：由观察者测算病损面积的大小;主观指标：采用直观类比标尺法（VAS）,纪录疼痛程度。结果 两组患者病损面积和VAS指标都有明显下降,治疗组总有效率为86.90%,对照组总有效率为81.70%,两组差异无统计学意义（P＞0.05）。结论 昆明山海棠口腔膜治疗糜烂型口腔扁平苔藓取得较好的疗效,具有临床推广价值。     

角膜缘上皮移植治疗眼球表面疾患8例

目的 观察用角膜缘上皮移植治疗翼状胬肉及化学伤后角膜表面血管翳性混浊效果。方法 对６例（９眼）翼状胬肉,２例（２眼）化学烧伤病人进行角膜缘上皮移植。结果 翼状胬肉患者视力均提高,６例角膜完全透明,角膜缘结构正常,化学患者角膜表面光滑透明,视力提高。结论 角膜缘干细胞移植治疗眼球表面疾病疗效确切,是再造角膜表面的良好术式。     

Upper gastrointestinal burns by peroxyacetic acid in children- a review of seven cases

Objective： To study the clinical features of upper gastrointestinal burns by peroxyacetic acid （PA） in children and improve its treatment and outcome. Methods： The clinical materials of 7 cases with upper gastrointestinal burns by PA including clinical presentation, treatment and outcomes were reviewed. Results： There were six boys and one girl. The concentration of the swallowed PA was from 10% to 20% and the amount was 3-10 ml. The mainly bums were located in esophagus in one case, stomach in three cases, both esophagus and stomach in three cases. The gastrostomy and operation of dilating esophagus were performed in the cases with esophageal stricture. The pyloroplasty or gastroduodenostomy was performed in the cases with pyloric obstruction. All the cases were followed up for 12-18 months, dysfunction of esophagus or（and） cardia as well as stiffness and hypodynamia of the stomach was showed in most of the patients. Conclusion： The degree of upper gastrointestinal burns by PA varied according to different concentrations of PA which was swallowed. Correct emergent measures in the acute stage of the burns was very important, gastric tube should be inserted and go through esophagus and pylorus and must be retained for 5-8 weeks to prevent the stricture of esophagus and pylortts, otherwise the tube could act as a passage of nutriment. Prophylaxis of upper gastrointestinal bums by PA is very important because the treatment of the burns is difficulty and the outcomes are not always satisfactory.     

苯酚灼伤并发中毒的临床处理研究

目的：探究分析苯酚灼伤并发中毒的临床救治处理对策。方法方便收集2015年2月―2016年2月广州中山大学附属第一医院收治的87例苯酚灼伤并发中毒患者临床救治相关资料,回顾分析其临床症状和救治、护理方法、治疗效果。结果87例患者有84例在伤后0.50~2 h内出现全身性中毒症状,灼伤面积越大,持续时间越长患者中毒症状越严重,全身10.00%以上灼伤患者肝肾功能受损较为严重;临床救治方法主要有创面处理、碱化尿液、利尿剂、补液、手术以及血液净化处理等;临床护理内容有创面护理、心理护理、呼吸通道护理、健康教育和饮食护理等;87例患者中有1例抢救无效死亡(无法行手术救治,发生急性肾衰而死亡﹚,86例成功治愈,在治疗1~4周后治愈出院。结论苯酚灼伤极易引起全身中毒,需及时采取对应的救治处理,排出毒物,同时实施系统护理。     

Cetrimide burn in an infant

A case of chemical burns due to cetrimide applied to the nappy area of an infant is recorded.