胡祖良, 张元海, 王新刚, 叶春江, 张建芬, 刘利平, 蒋瑞明, 倪良方, 韩春茂. 静脉结合皮下注射葡萄糖酸钙治疗氢氟酸烧伤[J]. 环境与职业医学, 2016, 33(1): 77-80. DOI: 10.13213/j.cnki.jeom.2016.15224
引用本文: 胡祖良, 张元海, 王新刚, 叶春江, 张建芬, 刘利平, 蒋瑞明, 倪良方, 韩春茂. 静脉结合皮下注射葡萄糖酸钙治疗氢氟酸烧伤[J]. 环境与职业医学, 2016, 33(1): 77-80. DOI: 10.13213/j.cnki.jeom.2016.15224
HU Zu-liang, ZHANG Yuan-hai, WANG Xin-gang, YE Chun-jiang, ZHANG Jian-fen, LIU li-ping, JIANG Rui-ming, NI Liang-fang, HAN Chun-mao. Delivery of Calcium Gluconate by Combination of Subcutaneous Injection and Intravenous Infusion for Hydrofluoric Acid Burns[J]. Journal of Environmental and Occupational Medicine, 2016, 33(1): 77-80. DOI: 10.13213/j.cnki.jeom.2016.15224
Citation: HU Zu-liang, ZHANG Yuan-hai, WANG Xin-gang, YE Chun-jiang, ZHANG Jian-fen, LIU li-ping, JIANG Rui-ming, NI Liang-fang, HAN Chun-mao. Delivery of Calcium Gluconate by Combination of Subcutaneous Injection and Intravenous Infusion for Hydrofluoric Acid Burns[J]. Journal of Environmental and Occupational Medicine, 2016, 33(1): 77-80. DOI: 10.13213/j.cnki.jeom.2016.15224

静脉结合皮下注射葡萄糖酸钙治疗氢氟酸烧伤

Delivery of Calcium Gluconate by Combination of Subcutaneous Injection and Intravenous Infusion for Hydrofluoric Acid Burns

  • 摘要: 目的

    探讨静脉结合皮下注射葡萄糖酸钙(CG)治疗氢氟酸烧伤的疗效及安全性。

    方法

    2006年1月至2013年8月共收治82例氢氟酸烧伤患者。在入院时创面皮下一次性注射CG,剂量为30~45 mg/cm2者9例,10~30 mg/cm232例,5~10 mg/cm2 41例;Ⅰ度创面按0.25~5.00 mg/cm2的剂量皮下注射或采用2.5% CG溶液湿敷。皮下注入CG总量1~5 g者57例,5~10 g 14例,10~20 g 10例,20~30 g 1例。同时动态监测血钙,根据血钙调整静脉补钙速度。

    结果

    82例氢氟酸烧伤患者均治愈。5例低钙血症患者在入院后4 h内得到纠正,71例患者血钙维持在正常范围,6例患者出现高钙血症。所有患者经过1个月以上随访,注射区域未见感染、皮下结节形成和皮肤坏死,也未见创面明显加深现象。

    结论

    静脉结合皮下注射CG是救治氢氟酸烧伤的有效方法,但皮下注射剂量应根据患者的伤情加以调整,避免剂量过大发生高钙血症。

     

    Abstract: Objective

    To evaluate the efficacy and safety of simultaneously using subcutaneous injection and intravenous infusion of calcium gluconate to treat hydrofluoric acid burns.

    Methods

    Eighty-two patients with hydrofluoric acid burns were admitted from January 2006 to August 2013. A one-time subcutaneous injection of calcium gluconate was administered to all the patients after admission at dosages of 30-45 mg/cm2 (9 cases), 10-30 mg/cm2 (32 cases), and 5-10 mg/cm2 (41 cases), respectively. For first degree burn areas caused by hydrofluoric acid, calcium gluconate was subcutaneously injected at a dosage of 0.25-5.00 mg/cm2, or wet dressing with 2.5% calcium gluconate solution was used for local treatment. The total dosages of calcium gluconate for subcutaneous injection varied by case:1-5 g for 57 cases, 5-10 g for 14 cases, 10-20 g for 10 cases, and 20-30 g for 1 case. Meanwhile, the level of serum calcium was dynamically monitored for all the patients involved, based on which the velocity of intravenously administrated calcium gluconate was regulated.

    Results

    All the 82 patients with hydrofluoric acid burns were cured at discharge. Specifically, 5 cases, showing hypocalcemia when admitted, were corrected immediately in the following 4 h after diagnosis; 71 cases were steady in the normal range of serum calcium; and the other 6 cases occurred hypercalcemia. No outstanding adverse effects, such as local infection, subcutaneous nodules, skin necrosis, or deepened burn wounds, were observed during the hospital stay and the one-month follow-up visit.

    Conclusion

    Subcutaneous injection in combination with intravenous infusion of calcium gluconate could be an effective method to treat hydrofluoric acid burns. The dosage of calcium gluconate for subcutaneous injection requires adjustment according the local wound degree to avoid hypercalcemia resulted from over-dosage.

     

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