目的探讨吸入性损伤的早期急救、确诊方法和综合治疗措施,以进一步提高其救治水平。方法 8例吸入性损伤患者,6例行紧急气管切开术。采用以下措施进行救治:应用气管镜诊断吸入性损伤程度,清理气道和气管、支气管灌洗;人工鼻湿化气道和防治感染;使用化痰药,并定时翻身叩背、振动排痰。结果气管镜检查见8例患者吸入性损伤程度分别为中度2例,重度5例,特重度1例。6例气管切开患者,1例于伤后1周内拔管,1例于伤后第3周拔管,4例于伤后1个月后拔管。痰培养6例发现细菌。治疗过程中用气管镜清理痰痂、气管脱落黏膜2例次,灌洗13例次。所有患者均救治成功。结论吸入性损伤尽早行支气管镜检查,有助于准确诊断损伤程度,清理气道,防止气道阻塞,灌洗液培养便于选择抗菌药物防治感染;中度以上吸入性损伤尽早行气管切开。 Objective To explore the early first aid, diagnosis and comprehensive treatment of inhalation injury to further improve its treatment level. Methods Eight patients with inhalation injury and six patients underwent emergency tracheotomy. The following measures were taken for treatment: bronchoscopy was used to diagnose the extent of inhalation injury, airway and trachea were cleaned up, bronchial lavage was performed, artificial nasal airway was wetted and infection was controlled, and phlegm medicine was used. Results In bronchoscopy, the degree of inhalation injury in 8 patients was moderate in 2 cases, severe in 5 cases and extra-severe in 1 case. Six patients underwent tracheotomy, one underwent extubation within one week after injury, one extubated at week three after injury, and four extubated at one month after injury. Six cases of sputum culture found bacteria. During treatment, sputum scabs were cleared with a bronchoscope, 2 cases of tracheal exfoliative mucosa and 13 cases of lavage. All patients were treated successfully. Conclusions Early inhalation injury bronchoscopy, help to accurately diagnose the degree of injury, clean the airway to prevent airway obstruction, lavage fluid culture to facilitate the selection of anti-bacterial drugs to prevent infection; moderate aspiration tracheotomy trachea as soon as possible.