探讨单纯面颈部烧伤或大面积烧伤合并吸入性损伤患者颈部水肿程度的变化趋势，降低气管切开患者非计划性拔管风险及颈部医源性压力性损伤发生率。

选择2023年6月至2024年12月首都医科大学附属北京积水潭医院烧伤整形与创面修复科收治的烧伤患者63例，其中单纯面颈部烧伤患者8例，大面积烧伤合并吸入性损伤患者55例。根据烧伤总面积将后者分为4个亚组：20%~29%总体表面积（TBSA）组（n=13）、30%~49%TBSA组（n=12）、50%~69%TBSA组（n=14）及≥70%TBSA组（n=16）。采用标准化颈围测量法动态观察各组患者颈部水肿程度变化，分析颈部水肿程度、气管套管留置时间与烧伤总面积的相关性。观察气管套管滑脱及固定带相关压力性损伤发生情况。

单纯面颈部烧伤组患者颈部水肿达峰时间为伤后24~40 h，20%~29%TBSA组、30%~49%TBSA组及50%~69%TBSA组均为伤后24~48 h，≥70%TBSA组为伤后16~60 h，各组患者颈部水肿达峰时间差异有统计学意义（P<0.05）。颈部水肿程度、气管套管留置时间均与烧伤总面积呈正相关（P<0.05）。观察期间未发生气管套管滑脱及固定带相关压力性损伤。

临床管理需根据烧伤患者伤后颈部水肿程度变化规律，在关键时间段加强动态监测，及时调整气管套管固定带松紧度，以预防压力性损伤及非计划性拔管。

To investigate the changing trends of neck edema in patients with isolated facial and neck burns or extensive burns combined with inhalation injury， reduce the risk of unplanned extubation and the incidence of iatrogenic pressure injuries in the neck among tracheostomy patients.

A total of 63 burn patients admitted to the Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital， Capital Medical University from June 2023 to December 2024 were enrolled， including 8 patients with isolated facial and neck burns and 55 patients with extensive burns combined with inhalation injury. The patients with extensive burns combined with inhalation injury were stratified into four subgroups based on total burn surface area (TBSA)： 20%–29% TBSA （n=13）， 30%–49% TBSA （n=12）， 50%–69% TBSA （n=14）， and ≥70% TBSA （n=16）. Standardized neck circumference measurements were used to dynamically record the severity of neck edema in each group， and the correlation between the severity of neck edema， the duration of intubation and total burn area was analyzed. Observed the occurrence of tracheal cannula dislocation or pressure injuries related to the fixation belt.

The peak time of neck edema was 24–40 hours post-injury in isolated facial and neck burns group，24–48 hours post-injury in 20%–29% TBSA group， 24–48 hours post-injury in 30%–49% TBSA group， 24–48 hours post-injury in 50%–69% TBSA group， and 16–60 hours post-injury in ≥70% TBSA group. The differences in peak edema time among the groups were statistically significant （P<0.05）. The severity of neck edema and the duration of intubation were positively correlated with total burn area （P<0.05）. During the observation period， there were no cases of tracheal cannula dislocation or pressure injuries related to the fixation belt.

In clinical management， according to the changing pattern of cervical edema after injury in burn patients， dynamic monitoring should be strengthened at key time points， and the tightness of the tracheal tube fixation belt should be adjusted in a timely manner to prevent pressure injuries and unplanned extubation.