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目的探讨以烧伤为主诊的肺爆震伤(BLI)的临床特征和救治方法。方法回顾性分析以烧伤为主诊的肺爆震伤39例患者资料,并用BLI评分方法评估其严重程度。结果 39例烧伤面积平均46.5%,其中Ⅲ°烧伤者Ⅲ°面积平均50.9%。按爆震伤评分,重度8例,中度14例,轻度17例。入院时均有程度不等的呼吸困难,13例严重者在12h内建立呼吸道和呼吸支持。入院时仅个别伤员X线胸片有改变,但24h内所有患者胸片均有阳性发现。中度以上的22例均行机械通气支持呼吸,呼吸支持平均4周。烧伤创面愈合时间平均27.8d。发生成人呼吸窘迫综合征(ARDS)6例,2例重度患者在48h内死亡。结论早期认识肺爆震伤,强化以呼吸支持为主的脏器支持和保护等综合性措施。
Objective To investigate the clinical features and treatment of lung blast injury (BLI) with burn. Methods A retrospective analysis of 39 patients with blast-induced lung injury was conducted and their severity was evaluated by BLI score. Results The average burn area of 39 cases was 46.5%. The average Ⅲ ° area of Ⅲ ° burns was 50.9%. According to knocking injury score, severe in 8 cases, moderate in 14 cases, mild in 17 cases. There were varying degrees of dyspnea on admission, and 13 severe cases established respiratory and respiratory support within 12 hours. Only a few individual patients admitted to hospital X-ray changes in chest X-ray, but within 24h all patients were positive for chest radiographs. Moderate or more than 22 cases of mechanical ventilation support breathing, respiratory support for an average of 4 weeks. Burns wound healing time average 27.8d. 6 cases of adult respiratory distress syndrome (ARDS) occurred, and 2 severe cases died within 48 hours. Conclusions Earlier knowledge of blast lung injury, strengthening of respiratory support-based organ support and protection and other comprehensive measures.