To analyze the clinical characteristics of patients with severe explosion injuries and the monitoring and treatment of severe injuries.

Nine patients with severe explosion injuries admitted to our hospital from September 2011 to August 2022 were selected as the subjects. The clinical data was collected: gender, age, injury mechanism, diagnosis, acute physiology and chronic health evaluation (APACHE Ⅱ), injury severity score (ISS), Glasgow coma score (GCS), ICU length of stay, injury site, surgical method and time, use of blood products, mechanical ventilation, use of vasoactive drugs and anticoagulants, renal replacement therapy and infection, Pre-and post-laboratory parameters were analyzed.

The average hospitalization time of the 9 patients in the Intensive Care Unit (ICU) was (32.0±24.9) days. There were 7 cases (77.78%) with invasive respiratory support for (21.4±20.9) days. Vasoactive drugs were used in 5 cases (55.56%) for (7.4±6.6) days. invasive arterial blood pressure (IABP) and central venous pressure (CVP) were detected in 8 cases (88.89%). There were 9 cases with different degree of coagulation dysfunction, 6 cases (66.67%) with component transfusion, and 8 cases (88.89%) with early anticoagulation treatment with heparin (Hep) or low molecular weight heparin (LMWH). 9 cases were treated with antibiotics for (17.3±12.7) days. Continuous renal replacement therapy (CRRT) was performed in 4 patients (44.44%), and the duration of CRRT treatment was (7.2±5.1) days. In the early stage (48 h), 6 cases (66.67%) received enteral nutrition support.D-Dimer (DD), K value, creatine kinase isoenzymes-MB (CK-MB), myoglobin (MYO), and cardiac troponin after treatment Protein I (cardiac troponin I, cTnI), total bilirubin (TBil), indirect bilirubin (IBil), aspartate aminotransferase (AST), lactate dehydrogenase (lactate dehydrogenase, LDH), serum creatinine (SCr), lactic acid (Lac), white blood cell count (WBC), absolute neutrophil count (ANC), ultrasonic The levels of hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) were significantly lower than those before treatment (P<0.05). In addition, hematocrit (HCT), platelet (PLT) count, alpha angle (angle), MA value and absolute lymphocyte count (ALC) increased after treatment (P<0.05). Eight cases (88.89%) were discharged after recovery, and one case was under long-term monitoring and treatment in the ICU due to persistent vegetative state.

Severe blast injuries are complex and challenging to treat. Comprehensive and systematic treatment in the ICU can improve laboratory indicators and prognosis of severe blast injuries.