胸部接触性电烧伤的临床分析
发布时间：2018-03-03 13:30
本文选题：接触性电烧伤 切入点：胸部 出处：《广西医科大学》2014年硕士论文 论文类型：学位论文
【摘要】：目的 探讨胸部接触性电烧伤的流行病学特点，临床特征，治疗方法及预后。 方法 回顾性分析我院烧伤整形外科及胸外科2003年1月至2013年12月间收住院的32例胸部接触性电烧伤患者的病例资料。对患者的一般资料进行流行病学分析、基础治疗方法总结。根据手术方式将资料分成3组，A组自体皮移植术9例，B组局部随意皮瓣修复术17例，C组轴型皮瓣修复术6例。分别对3组患者的基础治疗、手术时间、住院时间、手术次数、术后并发症及预后等资料进行对比分析。 结果 1：在32例病例资料中，男28例，女4例。平均年龄31.53岁±12.28岁，以18～36岁年龄段的发病率最高，占59.38%。职业分布主要集中在农民工及电工,农民工有17例，占53.13%。受伤原因以交流电接触伤为主,共30例，，雷电伤2例。统计出死亡4例，病死率为12.5%。 2：32例患者胸部烧伤创面面积为1%～9%TBSA，平均为（3.86±2.13）%TBSA。创面为电流“出口”而受损的有23例，占71.88%。胸腔内脏器官受损的Ⅳ型烧伤5例，发生率为15.63%。 3:对3组手术时间两两比较，植皮术组及局部皮瓣组手术时间均少于轴型皮瓣组（P㩳0.05），3组之间平均住院日两两比较均无统计学上差异（P＞0.05）。3组中修复创面需要的手术次数最多的是植皮术组，平均2.33次，其次是轴型皮瓣组1.5次，最少的是局部随意皮瓣组，平均1.29次。 4：术后并发症以创面感染发生率最高，达28.13%（9/32），其中植皮术组创面感染发生率为44.44%，皮片血运障碍发生率及疤痕增生发生率为22.22%,3项指标发生率均为3组中最高，轴型皮瓣组血运障碍、创面感染及脓胸的发生率均为16.67%，与其他组相比发生率最低。 结论 1：胸部接触性电烧伤常见于高压电接触伤，烧伤面积不大，死亡率较高，青年的男性农民工易发生，胸部创面大多为电流“出口”而受损，发生内脏损伤较罕见。 2：胸部接触性电烧伤创面均需要手术治疗，在创面周围组织条许好，无脏器损伤的胸部创面首选局部皮瓣转移，组织损伤面积大伴有胸腔脏器损伤的创面首选轴型皮瓣移植。 3:创面修复术后主要的并发症是缺损创面的感染及移植组织的局部血运障碍，植皮术的术后并发症发生率高于皮瓣移植术。
[Abstract]:Purpose. To investigate the epidemiological characteristics, clinical features, treatment and prognosis of contact electrical burns in the chest. Method. The data of 32 cases of thoracic contact electrical burn admitted from January 2003 to December 2013 in our hospital were analyzed retrospectively. The general data of the patients were analyzed by epidemiology. Methods of basic treatment were summarized. The data were divided into 3 groups: group A (n = 9), group B (n = 9), local random flap repair (n = 17) and group C (n = 6). Time of hospitalization, times of operation, postoperative complications and prognosis were compared and analyzed. Results. 1: of the 32 cases, 28 were male and 4 female. The average age was 31.53 卤12.28 years old. The incidence rate was the highest in the 180-36 age group, accounting for 59.38.The occupational distribution was mainly concentrated in migrant workers and electricians, and there were 17 cases of migrant workers. The main causes of injury were AC contact injury (30 cases) and lightning injury (2 cases). 4 cases died and the mortality rate was 12.5%. The area of thoracic burn wound in 2:32 patients was 1 and 9 TBSAs, the average was 3.86 卤2.13 TBSA.The wound surface was injured by electric current "outlet" in 23 cases (71.88%). There were 5 cases of type 鈪
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