ABSTRACT
Objective To review the experience in the management of burned patients inflicted by inhalation injury in our institute in the past 42 years. Methods Patients with inhalation injury were analyzed chronically in three different periods as 1958 to 1980, 1981 to 1990, and 1991 to 2000. Results The mortality rates in general and in terms of different degrees decreased obviously with the elapse of time. In other words, the rates were 48.93%, 26.60% and 8.53 for the above three periods. Conclusion The mortality of inhalation injury was decreased dramatically during the last decade in our institute. Five main measures consisting of inhalation of high concentration or pure oxygen, preventive tracheotomy, frequent tracheal lavage with small amount of lavage fluid at early stage of postburn, mechanical ventilation with PEEP and humidification as early as possible, and application of exogenous pulmonary surfactant contribute greatly to the decrement of death rate in the patients with inhalation injury.
ABSTRACT
Objective To study the morphological changes in peripheral blood cells and bone marrow cells of the patients suffering from mustard gas poisoning and their relationship with the degree of poisoning. Method The peripheral blood cells and marrow cells were examined morphologically after mustard gas poisoning. Results The total WBC count was reduced progressively in 44 patients, among them 10 patients showed granulocytopenia or agranulocytosis. Severe injury to eosinophils was seen also in the early period, and the percentage and absolute value of lymphocytes were significantly lowered too. However, platelets were not significantly influenced. The red cell count and hemoglobin level were elevated because of hemoconcentration. Blood marrow cells showed marked morphological changes. WBC became swollen with appearance of poisonous granules and vacuoles in their cytoplasm. Deformed lymphocytes (LY) could be found in the marrow cells of all the patients, mainly in the form of immature lymphocytes. It was shown that mustard gas produced serious damage to the hematopoitic cells of the bone marrow in the early period. Conclusions The examination of pheripheral blood and bone marrow cells is an important measure to determine the degree of mustard gas poisoning. The decrease in the absolute value of lymophocyte count and the time of its recovery, and degree of inhibition of hematopoiesis are closely related to the degree of mustard gas poisoning.