摘要
目的研究近5年北京积水潭医院烧伤重症监护病房收治的成人严重烧伤患者的流行病学特征。方法收集2016年1月至2021年1月在北京积水潭医院烧伤重症监护病房因严重烧伤住院的成年患者的病例资料,对其年龄、性别、职业、致伤元素、受伤场所、受伤季节、烧伤总面积、Ⅲ度烧伤面积、烧伤部位、吸入性损伤和复合伤、基础疾病、并发症、治疗结局、住院时间进行统计学分析。结果本研究共纳入223例患者,其中男173例,女50例,以中青年患者为主(92.83%)。职业分布方面工人占比最高(33.63%),5年间工人占比逐渐降低,而退休人员占比呈上升趋势(P<0.05)。火焰烧伤175例(78.48%),呈逐年增长趋势;电烧伤23例(10.31%),呈逐渐降低趋势(P<0.05)。受伤场所最多的是家中,共104例(46.64%),呈逐年递增趋势,其主要原因为燃气爆燃/爆炸(44.90%),呈间断增长趋势(P<0.05)。春季受伤例数最多(73例,32.74%),全年5月份最为高发(29例,13.00%)。烧伤总面积和Ⅲ度烧伤面积中位数分别为50%总体表面积(total body surface area,TBSA)、15%TBSA,电烧伤和化学烧伤相比于火焰烧伤主要分布于中小面积,但烧伤深度通常为Ⅲ度。共记录烧伤部位827处,无单一部位烧伤者,以双上肢(26.24%)、头面颈(23.82%)、双下肢(22.45%)最易受累。共162例(72.65%)有吸入性损伤,火焰烧伤是其主要原因(93.82%),而化学烧伤最易导致角膜烧伤(P<0.05)。总体治愈180例(80.72%)、死亡20例(8.97%)、稳定出院13例(5.83%)、放弃治疗10例(4.48%),老年患者中死亡和放弃治疗的比例高于中青年(P<0.05)。治愈组患者住院时间中位数为55d,且其住院时间与烧伤总面积、Ⅲ度烧伤面积呈线性正相关关系。死亡组患者住院时间中位数为13d,但住院时间与烧伤总面积、Ⅲ度烧伤面积无明显相关性。结论中青年男性仍是严重烧伤的高危人群,火焰烧伤是严重烧伤的主要原因,且常伴有吸入性损伤。退休后居家老人严重烧伤日益增多,且多合并基础疾病,易发生严重并发症,预后较差,应给予其足够重视,并加强烧伤预防工作。
Objective To investigate the epidemiological characteristics of adult patients with severe burns admitted to the BICU of Beijing Jishuitan Hospital in recent 5 years.Method The data of all severe burn hospitalized adult patients in the author’s unit from January 2016 to January 2021 were collected.Statistical analysis was made on the gender,occupation,injury elements,place of injury,seasonal variation,total burn area,third-degree burn area,injury site,inhalation injury and combined injury,basic diseases,complication,outcomes and the length of hospitalization.Result A total of 223 cases were included,175 cases(78.48%)were flame burns,23 cases(10.31%)were electric burns.The most injured places were in home,104 cases(46.64%),with an increasing trend.The main cause of flame burns in home was gas deflagration/explosion(44.90%),with an increasing trend(P<0.05).The number of injuries was the highest in spring(73,32.74%),and the highest month was May(29,13.00%).The median of total burn area and third degree burn area were 50%TBSA and 15%TBSA.Compared with flame burns,electrical and chemical burns were mainly distributed in small and medium areas,but the depth was usually third degree.A total of 827 injured sites were recorded.The upper limbs(26.24%),head and neck(23.82%)and lower limbs(22.45%)were the most vulnerable.A total of 162 cases(72.65%)had inhalation injury,and flame burn was the main cause(93.82%),while chemical burn was the most likely cause of corneal burn(P<0.05).Overall 180 cases(80.72%)were cured,20 cases(8.97%)died,13 cases(5.83%)were discharged steadily,and 10 cases(4.48%)gave up.The median length of hospitalization in the cure group was 55 days,and there was a positive linear correlation between the length of hospitalization and the total burn area and third-degree burns area.The median length of hospitalization in the death group was 13 days,There was no positive/negative linear correlation between the length of hospitalization and the total area or third-degree burns area.Conclusion Young and middle-aged men were still at high-risk of burns.Flame burn is a major cause of severe burns,often associated with inhalation injury.Elderly group always combined more basic diseases,were susceptible to severe complications and poor prognosis,so we should pay more attention to elderly burn prevention.
作者
张慧君
赵筱卓
王成
陈欣
陈辉
胡骁骅
沈余明
Zhang Huijun;Zhao Xiaozhuo;Wang Cheng;Chen Xin;Chen Hui;Hu Xiaohua;Shen Yuming(Department of Burns,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《中国医刊》
CAS
2022年第2期184-190,共7页
Chinese Journal of Medicine
基金
首都卫生发展科研专项(首发2020-2-1123)
中国科学院理化技术研究所所长基金。
作者简介
通信作者:沈余明,E-mail:shenyuming1963@163.com。
