电 烧 伤 和 化 学 烧 伤1 1. .一、电烧伤损害机制l伤情决定因素：接触时间、电流强度、电流性质、电流径路等。l不同组织的局部损害程度不同。l“跳跃式”深度烧伤。2 2. .临床表现1.全身性损害：恶心、心悸、头晕、意识障碍；昏迷，呼吸、心跳骤停。2.局部损害：入口和出口；损伤范围外小内大；渗出较一般烧伤重；经常出现进行性坏死 ；关节屈面可出现“跳跃式”伤口。3 3. .治疗1.现场急救：切断电源，心肺复苏。2.液体复苏：补液量高于一般烧伤；碱化尿液；利尿。3.早期清创，注意切开减张，包括筋膜切开减压。4.早期全身应用较大剂量抗生素。5.注射破伤风抗毒素。4 4. .电烧伤Electrical burns may show erythema and bullae from the heat of arcing current or may be non-descript with severe internal damage between the points of contact and exit of the current. 5 5. .电 烧 伤 The painful truth :The painful truth : This person lost the use of 3 fingers, This person lost the use of 3 fingers, which took over 7 months to heal.The which took over 7 months to heal.The thing that worries Overgrow / Growfaqthing that worries Overgrow / Growfaq is the fact that most people dont is the fact that most people dont understand, or believe that most of the understand, or believe that most of the time this beast kills and does so time this beast kills and does so without warning. without warning. Most Overgrow members wouldnt Most Overgrow members wouldnt want to be put into an electric chair, but want to be put into an electric chair, but will climb into one willingly while wiring will climb into one willingly while wiring a room, opening a ballast, building a room, opening a ballast, building their own ballasts or other devices, you their own ballasts or other devices, you name it. name it. Electricity can and will kill you if you Electricity can and will kill you if you dont respect it! dont respect it! 6 6. .7 7. .左手大鱼际部高压电击伤入口，组织碳化坏死左上肢高压电击伤，已切开减张左上肢切开减张8 8. .二、化学烧伤特点：某些化学物质接触人体后，除立即损伤外 ， 还可继续侵入或被吸收，导致进行性局部损害或全身性中毒。一般处理原则：大量清水冲洗，大量补液 ，利尿 ，深度烧伤早期清创植皮，急救时不用中和剂。化学毒物致伤者选用解毒剂或对抗剂。9 9. .1.强酸（硫酸、盐酸、硝酸）l组织蛋白凝固坏死，组织脱水；l无水疱，皮革样成痂，不向深部侵蚀，脱痂时间延缓；l急救时大量清水冲洗后按一般烧伤处理。酸烧伤1010. . 化 学 烧 伤1111. .2.腐蚀性酸l石炭酸：吸收入血，肾损害；清水冲洗后70%酒精冲洗。l氢氟酸：溶解脂质，侵入深部；大量清水冲洗后葡萄糖酸钙加入普鲁卡因局部注射。1212. .氢氢 氟氟 酸酸 烧烧 伤伤1313. .碱烧伤l组织脱水；皂化脂肪组织，碱离子能向深处穿透。l疼痛较剧，创面扩大加深，愈合慢。l冲洗时间长 ， 深度者早期切痂与植皮。l生石灰、电石烧伤在冲洗前应先去除伤处的颗粒或粉末 ， 以免冲洗时产热。1414. .磷烧伤l特点：与空气接触可自燃，产物有脱水作用 ，吸收后能引起肝 、肾、心、肺损害，导致全身中毒。l急救 ：浸入水中 ，外涂硫酸铜；忌用油质敷料，适用碳酸氢钠湿敷包扎。深度创面尽早切除与植皮。1515. .