人类免疫缺陷病毒感染者烧伤后的管理和诊疗体会  

The experience of management and treatment of the burned AIDS patients

作　　者：王君[1] 汪虹[1] 唐宗联[1] 江河[1] 曾明[1] 刘海平[1] 

机构地区：[1]昆明医学院第二附属医院烧伤科,云南昆明650101

出　　处：《世界感染杂志》2009年第2期104-106,共3页World Journal of Infection

摘　　要：目的探讨人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染者烧伤后的管理，诊疗措施。方法对本科1999年6月至2008午12月间收治的14例HIV感染者烧伤后的临床特点进行分析、总结。结果本组病例均在输血前、手术前常规检查时发现有HIV感染，入院时患者常隐瞒吸毒、性乱史。都伴有丙型肝炎、乙型肝炎病毒血清学标志物阳性及梅毒、尖锐湿疣等情况。吸毒后引起烧伤较多见，局部常有深度烧伤。诊断后均采取单间病房隔离治疗，实行专人专管，固定换药器械，医用垃圾即时浸泡消毒。创面采用包扎治疗、尽快手术修复等措施。在烧伤常规治疗基础上，注意增强免疫力及预防真菌等机会性感染。对尚有毒瘾的病人，使用非成瘾性止痛药，并留家属陪护。治疗结果除2例中途放弃外，12例创面愈合，其中2例因CD4＋细胞低于200个／μL转云南省艾滋病关爱中心继续治疗。结论HIV感染者烧伤后具有传播艾滋病的高度危险性，应制定、完善医患及家属的规章管理制度加以防范，针对其临床特点进行诊疗、加强对家属的教育与合作可取得满意的治疗效果。Objective To discuss the management and treatment of the burned AIDS patients. Methods Analysis of the summarized clinical characters of the 14 burned AIDS patients from June, 1999 to December, 2008 in my hospital. Results Patients were found being infected by HIV in routine inspection before blood transfusion and operation, but drug abusing and multiple sexes were concealed, mostly with HCV, HBV positive effect, syphilis and condyloma acuminatum etc. Burning is mostly happened after the abuse of drug, partly with deep burning wound surface. Cases were insulated in single rooms after diagnosis, and got special tending. Meanwhile, the changing dressing and apparatus were fixed and the medical rubbish were sterilized immediately. The wound surface were given treatment of bandage and immediate operation. Besides the routine treatment, measures of improving immunity and precaution of fungus were taken. As to patients with constant drug addiction, non-addiction paregoric drugs are used, and family numbers are required to give the tendance. After receiving the treatment, 12 cases with wounds repaired completely, with 2 cases deserting treatment. 2 cases were sent to Yuunan regarding center hospital, since their CD4＋ cell is lower than 200/μL. Conclusions The burned aids patients have the danger to infect with AIDS, so that it＇s necessary to make a management for patients and family numbers, to give the treatment according to the character of the disease. In addition, strengthen the education and cooperation for relevants can gain the satisfying treatment results.

关 键 词：艾滋病 烧伤 管理 诊疗 

分 类 号：R644[医药卫生—外科学] R512[医药卫生—临床医学]