本文選題：接觸性電燒傷　切入點：胸部　出處：《廣西醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的 探討胸部接觸性電燒傷的流行病學特點，臨床特征，治療方法及預后。 方法 回顧性分析我院燒傷整形外科及胸外科2003年1月至2013年12月間收住院的32例胸部接觸性電燒傷患者的病例資料。對患者的一般資料進行流行病學分析、基礎(chǔ)治療方法總結(jié)。根據(jù)手術(shù)方式將資料分成3組，A組自體皮移植術(shù)9例，B組局部隨意皮瓣修復術(shù)17例，C組軸型皮瓣修復術(shù)6例。分別對3組患者的基礎(chǔ)治療、手術(shù)時間、住院時間、手術(shù)次數(shù)、術(shù)后并發(fā)癥及預后等資料進行對比分析。 結(jié)果 1：在32例病例資料中，男28例，女4例。平均年齡31.53歲±12.28歲，以18～36歲年齡段的發(fā)病率最高，占59.38%。職業(yè)分布主要集中在農(nóng)民工及電工,農(nóng)民工有17例，占53.13%。受傷原因以交流電接觸傷為主,共30例，，雷電傷2例。統(tǒng)計出死亡4例，病死率為12.5%。 2：32例患者胸部燒傷創(chuàng)面面積為1%～9%TBSA，平均為（3.86±2.13）%TBSA。創(chuàng)面為電流“出口”而受損的有23例，占71.88%。胸腔內(nèi)臟器官受損的Ⅳ型燒傷5例，發(fā)生率為15.63%。 3:對3組手術(shù)時間兩兩比較，植皮術(shù)組及局部皮瓣組手術(shù)時間均少于軸型皮瓣組（P㩳0.05），3組之間平均住院日兩兩比較均無統(tǒng)計學上差異（P＞0.05）。3組中修復創(chuàng)面需要的手術(shù)次數(shù)最多的是植皮術(shù)組，平均2.33次，其次是軸型皮瓣組1.5次，最少的是局部隨意皮瓣組，平均1.29次。 4：術(shù)后并發(fā)癥以創(chuàng)面感染發(fā)生率最高，達28.13%（9/32），其中植皮術(shù)組創(chuàng)面感染發(fā)生率為44.44%，皮片血運障礙發(fā)生率及疤痕增生發(fā)生率為22.22%,3項指標發(fā)生率均為3組中最高，軸型皮瓣組血運障礙、創(chuàng)面感染及膿胸的發(fā)生率均為16.67%，與其他組相比發(fā)生率最低。 結(jié)論 1：胸部接觸性電燒傷常見于高壓電接觸傷，燒傷面積不大，死亡率較高，青年的男性農(nóng)民工易發(fā)生，胸部創(chuàng)面大多為電流“出口”而受損，發(fā)生內(nèi)臟損傷較罕見。 2：胸部接觸性電燒傷創(chuàng)面均需要手術(shù)治療，在創(chuàng)面周圍組織條許好，無臟器損傷的胸部創(chuàng)面首選局部皮瓣轉(zhuǎn)移，組織損傷面積大伴有胸腔臟器損傷的創(chuàng)面首選軸型皮瓣移植。 3:創(chuàng)面修復術(shù)后主要的并發(fā)癥是缺損創(chuàng)面的感染及移植組織的局部血運障礙，植皮術(shù)的術(shù)后并發(fā)癥發(fā)生率高于皮瓣移植術(shù)。
[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 鹵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 鹵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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