2024 年 09 月 10 日

奇美醫療財團法人奇美醫院整形外科暨燙傷中心主治醫師 葉敬淳

【工廠工人全身55%重度燒燙傷,奇美醫院利用科技關注病情進展,全力搶救】

案例:『五十歲郭先生,任職於臺南市某傳產工廠。某日工作時不慎跌入儲存鋼管冷卻水的水槽,當時水溫高達攝氏八十度,現場同事雖立即搶救拉出,但因郭先生肚臍以下半身浸泡在熱水中長達十秒鐘,造成全身燒燙傷,緊急送至柳營奇美醫院急診室處置,由於體表面積55%深二度至三度嚴重燙傷,又轉送永康奇美醫院燒燙傷中心治療。

郭先生因燒燙傷面積過大,面臨敗血症、休克、呼吸衰竭及其他併發症可能導致死亡的風險。奇美醫院燒燙傷醫護團隊善用醫療資訊系統,確實掌握郭先生病情變化,並使用人工智慧模型幫忙整合分析複雜的醫療數據,讓郭先生及家人清楚了解病情進展,增強了他們面對治療過程的信心。奇美醫院社工也及時介入,協助家屬順利申請各項補助,減輕他及家人的生活及經濟壓力。

在醫療團隊的努力下,郭先生前後共經歷五次清創植皮手術,終於在住院七十餘日後順利出院,目前接受復健治療與疤痕護理中。』

職業性燒燙傷占住院病人職業傷害醫療費用最高比例

奇美醫療財團法人奇美醫院整形外科暨燙傷中心主治醫師葉敬淳說明,燒燙傷是常見的嚴重外傷之一,大部分都與工作環境相關,職業性燒燙傷更會造成嚴重的職業傷害,為住院病人職業傷害醫療費用中比例最高。職業性燒燙傷常發生於青壯年工作者,造成的傷害、失能或死亡,對個人家庭及社會都是沉重的一項負擔,也影響國家的經濟生產力。

奇美醫療財團法人奇美醫院承擔大臺南區的急重症醫療任務,設有燒燙傷中心收治各種燒燙傷病人。根據奇美醫院統計民國111年1月至民國111年12月醫院一年內因燒燙傷至急診室就醫的個案數,共計388人,其中與工作相關的職業性燒燙傷占41%;與非職業性燒燙傷相比較,此類病人的年紀相對較年輕且以男性為主,住院比例也較高。而在住院的傷患當中,有一部分屬於重大傷燙傷,即受傷面積佔體表面積20%以上的病例。

奇美醫院開發住院燒燙傷病人病情預測系統,醫病溝通成利器

燒燙傷可能導致的併發症很多,其中感染最為常見,尤其是灼傷總體表面積在30%以上、全層皮膚灼傷、極端年齡(年輕人或老人)、或灼傷累及腿部或會陰部,感染風險會更高。其他常見的併發症按發生頻率順序依次為肺炎、蜂窩組織炎、尿路感染和呼吸衰竭,而吸入性損傷者極易發生肺炎。

奇美醫療財團法人奇美醫院整形外科暨燙傷中心主治醫師葉敬淳指出,此外,重度燒傷病人的病情通常會出現劇烈波動,有時甚至在數小時或數分鐘內發生變化。因此,奇美醫院燙傷中心團隊利用長久累積大型燒燙傷病人數據庫,並運用人工智慧和機器學習技術,開發出「住院燒燙傷病人病情預測」系統,無縫接軌並融入現有的醫院資訊系統(HIS)中。

奇美醫療財團法人奇美醫院整形外科暨燙傷中心主治醫師葉敬淳表示,奇美醫院燒燙傷中心「住院燒燙傷病人病情預測」系統,在病人入院及病情變化時,可獲取即時臨床數據並有效整合,預測將來發生死亡或嚴重併發症之機率、需要住院的時間、需要手術治療的可能性等疾病進展,幫助醫護團隊迅速做出更精準的個人化治療決策,從而改善病人的預後。對於病人端來說,現今病人與家屬對於醫療品質與決策溝通日益重視,如能在傳統影像跟數據之外輔以人工智慧圖表進行病情說明解釋,可望成為醫病溝通關係的一大利器。

奇美醫療財團法人奇美醫院  整形外科暨燙傷中心主治醫師 葉敬淳

【專長】急慢性問題傷口治療、一般整形手術、燒燙傷治療及重建、顏面神經麻痺相關疾患(眉毛、眼瞼、嘴角下垂)等。

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