特别重大火灾爆炸事故眼耳部损伤伤员伤情分析  

Analysis of Eye and Ear Injury from a Devastating Fire Blast

作　　者：王欢 何久智 陈孝储[2] 靳景云[2] 王晓瑜[2] 孙圣凯[2] 王中军[3] 

机构地区：[1]武警辽宁省总队丹东市支队后勤处卫生队,辽宁丹东118009 [2]武警后勤学院附属医院 [3]武警后勤学院卫生勤务学教研室

出　　处：《解放军预防医学杂志》2017年第4期317-319,323,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：国家自然科学基金面上项目(No.71473265)

摘　　要：目的探讨某特别重大火灾爆炸事故眼耳部损伤伤员伤情特点。方法回顾性分析事故中某三甲医院收治的53例眼耳部损伤伤员临床资料。结果致伤原因:眼部主要为电光热灼(70.27%),耳部则主要为爆震冲击波(93.94%)。损伤部位:眼部眼的附属器及眼球为高发部位,其中眼睑和角膜较为集中。耳部的中耳为高发部位,主要损伤集中在鼓膜。伤情种类:眼部的角膜挫伤、眼睑挫裂伤、结膜下出血、眼部热烧伤多于其他种类;耳部伤情则以鼓膜穿孔和爆震性耳聋为主。合并伤:眼部主要合并表皮伤害(擦伤)、开放性伤害(割、刺、撕裂伤)、烧伤及化学性灼伤;耳部主要合并开放性伤害(割、刺、撕裂伤)。结论特大火灾爆炸事故中伤员眼耳部损伤较为高发,伤情呈现出一定规律,且救治前期部分损伤不易被发现,应引起足够的重视。同时,针对此类事故救援,应着重从熟练掌握眼耳爆炸伤情种类、筛查原则、治疗措施等方面进一步加强针对性研究和培训,以最大程度预防和减少爆炸事件中眼耳伤员伤残发生。Objective To explore the characteristics of eye and ear injury from a catastrophic fire blast.Methods The clinical data of 53 cases of eye and ear injury admitted to a hospital was retrospectively studied.Results Eye injuries mainly resulted from electric light burning（70.27%）while ear injuries were mainly due to detonation shock waves（93.94%）.In terms of the sites of injury,accessory organs of eyes and eyeballs were most vulnerable,especially the eyelids and cornea.The middle ear was was a high-risk area,and injuries were mostly in the eardrum.As for injury types,eye cornea contusion,eyelid contusion,subconjunctival hemorrhage,ocular thermal burns were more common than other types.Ear injuries were mainly tympanic membrane perforation and detonation-caused deafness.Eye injuries were usually combined with skin injuries（bruise）,open injuries,burns and chemical burns,whereas ear injuries were combined open injuries.Conclusion Eye and ear injuries are relatively common during catastrophic fire blasts.Despite the regularities of injuries,some injuries are elusive before treatment.We should continue to strengthen research and training on classification of eye and ear injuries,find more effective methods of screening and improve the efficacy of therapies to minimize the incidence of disability of eyes and ears caused by explosions.

关 键 词：爆炸 火灾 眼耳部损伤 应急救援 

分 类 号：R129[医药卫生—环境卫生学]