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目的探讨急性氨吸入损伤的临床特征及救治要点。方法对168例急性氨吸入损伤者的临床表现、实验室检查、治疗及转归等临床资料进行回顾性分析。结果 168例急性氨吸入损伤者中刺激反应74例,急性中毒94例,其中急性氨中毒临床特征为吸入氨气后可立即对呼吸道产生强烈的刺激和腐蚀;重度氨中毒的死因主要是肺水肿、坏死黏膜脱落致大咯血或气道阻塞、继发性呼吸道感染及严重并发症;急性氨中毒救治要点是潜伏期内绝对卧床,正确应用肾上腺皮质激素,合理氧疗,重症者早期行气管切开,全病程监控呼吸道感染,防治并发症。结论氨吸入后可立即造成呼吸道严重损害,掌握关键救治技术可减少伤亡率,避免后遗症。
Objective To investigate the clinical characteristics of acute ammonia inhalation injury and its main points of treatment. Methods A retrospective analysis was performed on the clinical manifestations, laboratory tests, treatment and prognosis of 168 patients with acute ammonia inhalation injury. Results Acute ammonia inhalation injury in 168 cases of irritation in 74 cases, 94 cases of acute poisoning, of which acute ammonia poisoning clinical features of ammonia inhalation immediately after the strong respiratory irritation and corrosion; death caused by severe ammonia poisoning is mainly pulmonary edema , Necrotic mucosal shedding caused by a large hemoptysis or airway obstruction, secondary respiratory tract infections and serious complications; acute ammonia poisoning treatment is the absolute bed latency, the correct application of adrenocorticotropic hormone, reasonable oxygen therapy, severe tracheotomy early , The whole course of monitoring respiratory tract infection, prevention and treatment of complications. Conclusions Ammonia inhalation can cause serious respiratory tract injury immediately. To master the key treatment techniques can reduce the casualty rate and avoid sequelae.