烧伤患者吸入性损伤和肺部感染的发生特点及其对死亡的影响

为了评价吸入性损伤和肺部感染的发生特点及其对死亡的影响,总结了我科近14年住院治疗的热力烧伤患者940例,其中吸入性损伤175例,轻度15例。全部治愈,中度25例,死亡13例,死亡率为52.0％,重度35例。死亡31例,死亡率为88.6％,统计分析表明,合并吸入性损伤者69.3％在密闭空间发生,同时伴有面部烧伤者达96.0％。随着烧伤面积的增加,吸入性损伤发生率和肺部感染的发生率相应增加,有吸入性损伤肺部感染较无吸入性损伤肺部感染率为高(P<0.01),发生时间早,两组同等烧伤面积、深度、年龄患者、有吸入性损伤组发生死亡的危险比无吸入性损份组大17.2倍(P<0.001)。烧伤面积、深度和年龄相近,合并肺部感染者明显增加了死亡的机会(P<0.001)。

The characteristics of inhalation injury and pulmonary infection in burn patients and the influence on their mortality

940 patients with thermal injury during the past 14 years were reviewed. Of them, inhalation injury was diagnosed in 75 patients, including 15 mild injury who all survived, 25 moderate injury, of whom 13 died with a mortality rate of 52.0% and 35 severe injury, of whom 31 died with a mortality rate of 88. 6%. The data showed that 70% of burn that caused inhalation mjury occurred in a closed space and 96% of which also caused facial injury. With the burn extent increasing, the incidence of inhalation in- jury and pulmonary infection rise correspondingly. The time and incidence of pulmonary infection in the patients with inhalation injury was earlier and higher than that in those without inhalation injury (P<0.01). With similar burn area and age, the risk of death in the patients with inhalation injury was 17. 2 times of the patients without inhalation injury (P<0.001). Pulmonary infection further increased mortality of the patients(P< 0.001).