烧伤合并吸入性损伤气管切开时机的临床研究

目的总结烧伤合并吸入性损伤气管切开术的时机选择，以提高患者治疗效果。方法选择我院于2008年7月至2013年6月收治的烧伤合并吸入性损伤急者共35例为研究对象，按患者气管切开术不同时机分为紧急组6例和预防组29例．紧急组在行气管切开术前，有明显的呼吸困难，预防组为在气管切开术前，未出现明显的通气、换气障碍患者。比较两组患者治疗前后的生命体征，气管切开术后呼吸机使用情况、气管切开时间、MODS发生率和死亡率。结果术后预防组与紧急组各项指标有统计学差异（P〈0．05）。两组在气管切开时间、MODS发生率和死亡率方面有统计学意义（P〈0．01），但在呼吸机使用方面无统计学差异（P〉0．05）。结论为了提高烧伤合并吸入性损伤患者的治疗效果，有必要根据患者具体情况，尽早行预防性气管切开术，以改善生命体征、降低MODS发生和死亡风险。

Clinical Study on the Tracheotomy Opportunity for Burn Patients with Inhalation Injury

Objective To summarize the tracheotomy opporttmity for bum patients with inhalation injury, so as to improve the therapeutic effect. Methods 35 bum patients with inhalation injury in our hospital from July 2008 to June 2013 were selected as the research objects, and divided into the emergency group （n = 29） and prevention group （n = 6） according to the tracheotomy opportunity. Patients in the emergency group had obvious dyspnea before tracheotomy, while patients in the prevention group had not ventilation barrier. The vital signs before and after treatment, ventilator used after tracheotomy, tracheotomy time, incidences of MODS and death were compared between two groups. Results There were statistical differences between two groups in the vital signs （P 〈0.05）. There were significant statistical differences between two groups in the tracheotomy time, incidences of MODS and death （P 〈0.01）, but there was no statistical differences between two groups in the ventilator used after tracheotomy （P〉0.05）. Conclusions In order to improve the therapeutic effect of bum patients with inhalation injury, it is necessary to take prophylactic tracheotomy according to patients＇ specific conditions to improve vital signs, and reduce the risk of MODS and death.