氨烧伤并发的肺实质损害

目的:探讨氨烧伤合并肺实质损害病人的临床特点和治疗措施。方法:结合相关文献的复习,分析了3例合并严重肺实质损害的氨烧伤病人的治疗经验。结果:病人有如下的临床特点:1早期即有明显的呼吸困难。早期以吸气性呼吸困难为主,后期则以呼气性呼吸困难为显著。2均有不同程度的急性肺水肿表现。3早期气管切开虽有效,但并不能完全缓解呼吸困难。4均有遗留有明显的肺实质损害如肺纤维化,肺脓肿、空洞,支气管扩张,肺顺应性下降等。2例死亡。结论:氨烧伤并发的肺实质损害者预后极为凶险。氧疗、尽早短期大量应用糖皮质激素、早期气管切开、呼吸机辅助呼吸、湿化气道和应用支气管肺泡灌洗技术和抗感染治疗同等重要。

Ammonia Burn Complicatied with Pulmonary Parenchyma Lesion

Objective: To implore the clinical character and treatment strategy of ammonia burn complicated with severe pulmonary parenchyma lesion. Methods: To analysis the clinical characters and treatment projection of the ammonia burn complicated with severe pulmonary parenchyma lesion in 3 patients combined with reviewing relatively articles. Result: 2 out of 3 patients died. All of the patients appeared those characteristics: Dyspnea was obvious at the beginning after injury, inspiratory dyspnea at the early time and expiratory dyspnea during the later time. All of the patients have the pneumonedema. Trachecotomy was some effective but dyspnea can not remittent uncompletely. All of the patients have the severe pulmonary parenchyma lesion as pulmonary fibrosis, pulmonary abscess, pulmonary cavity, bronchiectasis and pulmonary compliance descent. Conclusion: The prognosis of ammonia injury complicated with pulmonary parenchyma lesion is extremely pernicious. Tracheotomy, oxygen therapy, large amount of Dexamethasone intravenous drip in shout time, respirator support, trachea humidification and bronchovesicular lavation was more important besides anti-infectious therapy and burned skin repair.