化学灼伤的诊疗探讨

目的 总结治疗１９０例化学灼伤的临床经验，并对其诊疗原则进行探讨。方法 顺顾性分析我院１９８５年１月～１９９８年１月收治的１９０例化学灼伤的临床资料。结果 １９０例病人中，７７．３７％的患者其灼与工作中的意外事故有关，致伤化学物质多达１７种，多数患者有手、足部位的灼伤，平均灼伤面积为４．５０％。经治疗，痊愈１８５例，死亡５例。结论 化学灼伤的诊断要考虑到诸方面的因素，力求准确；化学灼伤后要及时清除创面残化学物质，持续冲洗，适当使用中和剂；对毒性化学物质灼伤应及时采取有效措施，防止毒物吸收中毒；同时还要根据患者病情，因人施治。

Study on the diagnosis and treatment of chemical burns

Objectives To sum up our clinical experience of treating 190 cases of chemical burns and to discuss the fundamental principles in managing chemical burns. Methods A retrospective review from Jan, 1985 to Jan,1998 was conducted on the patients who suffered from chemical burns and were treated in our burn unit.Result Of 190 burned patients,77.37% were related to accidents during work.There were 17 different chemical agents involved. The majority of burns involved the hand and foot with an average burned area of 4. 5 %. 185 patients were cured and 5 died. Conclusions Correct diagnosis of chemical burns can be acquired by analysingcarefully history of case, nature of agents and clinical symptoms etc. The general principles of chemical burns include prompt debridement, copious irrigation, proper use of antidotes and prevention of systemic toxicosis. Individualtreatment should be considered according to the personal condition of patient.