吸入性损伤患者气管切开的时机与指征

目的：探讨大面积烧伤伴吸人性损伤患者气管切开的时机与指征。方法与结果：烧伤后1～24h行气管切开术124例，死亡24例；24h后行气管切开术51例，死亡28例。气管切开时颈部有环状或半环状焦痂21例，伴头面部严重烧伤90例，烧伤后口唇黏膜水肿外翻似“鱼嘴状”32例，口鼻内大量血清样渗出37例。结论：大面积烧伤伴吸人性损伤时喉梗阻危象的发生是导致烧伤患者死亡的重要原因，强调在烧伤后早期及时进行气管切开术，可降低患者喉梗阻危象的发生率和死亡率。

The time and indication for tracheotomy when inhalation injury

OBJECTIVE: To discuss the time and indication of tracheotomy for patients with inhalation injury. METHOD AND RESULT: One hundred and twenty four cases were under tracheotomy in 1-24 hours after burn in which 85 were gentle (11 died after operation), 22 moderate (9 died post-operation), 17 severe (11 died post-operation), 24 hours later there were 51 cases were operated in which the gentle 12 (8 died after operation), the moderate 34 (15 died post-operation) and the severe 5 (5 died post-operation). There were 5 patients had died before tracheotomy. There were 21 cases with cervical annular and deminannular eschar, 90 cases with severe burn in head and face, and 32 cases with fish mouths, 37 cases with blood serum bleeding in mouth and nose cavities. CONCLUSION: The crisis of larynx obstruction is the most important factor of causing death, and the earlier tracheotomy in patients with inhalation injury can reduce the incidence of larynx obstruction crisis and mortality.