2997例皮肤软组织损伤住院患者的回顾性分析  

Retrospective analysis of 2997 inpatients with skin and soft tissue injuries

作　　者：杨义[1] 褚万立[1] 冯光[1] 张海军[1] 郝岱峰[1] Yang Yi;Chu Wanli;Feng Guang;Zhang Haijun;Hao Daifeng(Wound Repair Center of Department of Burns and Plastic Surgery,the Fourth Medical Center of PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第四医学中心烧伤整形科创面修复中心,北京100048

出　　处：《中华烧伤杂志》2020年第9期821-829,共9页Chinese Journal of Burns

基　　金：北京市自然科学基金面上项目(7182160)。

摘　　要：目的分析皮肤软组织损伤住院患者的流行病学特征以及相关诊疗信息。方法回顾性分析解放军总医院第四医学中心(下称笔者单位)2014年1月1日—2018年12月31日收治的符合入选标准的皮肤软组织损伤住院患者的病历资料。统计如下指标:性别、年龄、创面病程、基础性疾病,创面类型、部位和创面微生物培养结果,治疗方式和结局,医疗费用支付类型、住院天数及住院费用。对数据行Mann-Whitney U检验、Kruskal-Wallis H检验、χ2检验。结果(1)笔者单位5年间共收治2997例符合入选标准的患者,男1803例(60.16%)、女1194例(39.84%),本组患者5年间性别分布差异明显(χ2=13.203,P<0.05),女性患者年龄明显高于男性患者(Z=-6.387,P<0.01)。急性创面患者882例(29.43%),慢性创面患者2115例(70.57%),本组患者5年间急慢性创面分布差异明显(χ2=66.806,P<0.01)。慢性创面患者的年龄明显高于急性创面患者(Z=-12.582,P<0.01)。共计1910例患者合并基础性疾病,共3847例次,常见基础性疾病依次为糖尿病1151例次(29.92%)、高血压884例次(22.98%)、冠状动脉粥样硬化性心脏病414例次(10.76%)、陈旧性脑梗死258例次(6.71%)、截瘫258例次(6.71%)。慢性创面患者合并基础性疾病例数明显多于急性创面患者(χ2=130.649,P<0.01)。(2)本组患者常见创面类型依次为术后难愈性创面、烧伤创面、糖尿病足溃疡、压疮、皮肤软组织感染。本组患者5年间创面类型分布差异明显(χ2=342.265,P<0.01)。本组患者共3957处创面。常见创面部位依次为足部、腿部、胸部等。976例患者行创面微生物培养,719例(73.67%)患者结果为阳性,257例(26.33%)患者结果为阴性。慢性创面患者的创面微生物培养阳性率明显高于急性创面患者(χ2=33.981,P<0.01)。急性创面患者中单纯感染111例(72.08%)、混合感染43例(27.92%),慢性创面患者中单纯感染364例(64.42%)、混合感染201例(35.58%)。719例患�Objective To analyze the epidemiological characteristics and the related information on the diagnosis and treatment of inpatients with skin and soft tissue injuries.Methods The medical records of inpatients with skin and soft tissue injuries who were admitted to the Fourth Medical Center of PLA General Hospital(hereinafter referred to as the author′s unit)from January 1,2014 to December 31,2018,conforming to the study criteria,were retrospectively analyzed.The indexes included inpatients′gender,age,wound course,underlying disease,wound type,wound site,and wound microbiological culture result,methods and outcome of treatment,type of medical payment,hospital day,and hospitalization cost.Data were statistically analyzed with Mann-Whitney U test,Kruskal-Wallis H test,and chi-square test.Results(1)A total of 2997 inpatients,conforming to the study criteria,were admitted to the author′s unit during the 5 years.There were 1803(60.16%)males and 1194(39.84%)females.The distribution of gender of patients showed significant differences during the 5 years(χ2=13.203,P<0.05).The age of female patients was significantly older than that of male patients(Z=-6.387,P<0.01).There were 882(29.43%)patients with acute wounds and 2115(70.57%)patients with chronic wounds.The distribution of acute wounds and chronic wounds of patients showed significant differences during the 5 years(χ2=66.806,P<0.01).The age of patients with chronic wounds was significantly older than that of patients with acute wounds(Z=-12.582,P<0.01).A total of 1910 patients(3847 cases)were complicated with underlying diseases.The common underlying diseases orderly were diabetes 1151(29.92%)cases,hypertension 884(22.98%)cases,coro-nary atherosclerotic heart disease 414(10.76%)cases,old cerebral infarction 258(6.71%)cases,and paraplegia 258(6.71%)cases.More patients with chronic wounds were complicated with various underlying diseases compared with patients with acute wounds(χ2=130.649,P<0.01).(2)The common types of wounds were postoperative non-healing wounds

关 键 词：软组织损伤 感染 伤口愈合 住院患者 

分 类 号：R644[医药卫生—外科学] R248.2[医药卫生—临床医学]