小面积烧伤患者出院后生存质量及其影响因素的研究  

Quality of life and its influencing factors in patients with small area burns after discharge

作　　者：胡伦阳 王宝丽 侯文佳 周万芳 施靖 蒋勇 伍国胜 孙瑜 夏照帆 Hu Lunyang;Wang Baoli;Hou Wenjia;Zhou Wanfang;Shi Jing;Jiang Yong;Wu Guosheng;Sun Yu;Xia Zhaofan(Department of Burn Surgery,People′s Republic of China,Burn Institute of Chinese People′s Liberation Army,Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury,Chinese Academy of Medical Sciences,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院烧伤外科,全军烧伤研究所,中国医学科学院烧伤暨烧创复合伤救治关键技术创新单元,上海200433

出　　处：《中华损伤与修复杂志（电子版）》2021年第3期216-223,共8页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：国家自然科学基金(81930057,81772076);中国医学科学院医学与健康科技创新工程项目(2019-I2M-5-076);海军军医大学高等级成果培植计划(2018-CGPZ-B03)。

摘　　要：目的对小面积烧伤患者群体出院后生存情况进行调查,并探讨影响其生存质量的相关危险因素。方法选择海军军医大学第一附属医院烧伤外科2017年1月至2018年12月收治的符合要求的123例小面积烧伤患者,并收集其人口学特征资料和烧伤疾病相关资料,包括年龄、性别、学历、婚姻状况、付费方式、烧伤面积、烧伤种类、吸入性损伤、气管切开、住院时间、住ICU时间和并发畸形。采用电话随访并采用健康调查(SF-36)简表、抑郁自评量表(SDS)、事件影响(IES-R)量表和烧伤后应对方式(CBQ)量表对患者进行调查,参照SF-36量表中国量化标准及评价参考值对本研究SF-36量表得分情况的8个方面进行评价,使用斯皮尔曼相关性分析探讨烧伤患者临床指标与SDS得分和CBQ量表得分之间的相关性,并将烧伤患者临床指标纳入单因素、多因素分析,探讨影响烧伤患者出院后抑郁及应对能力的独立危险因素。结果纳入本研究的小面积烧伤患者平均年龄为(47.3±16.4)岁,男(69.1%)为主。中位烧伤面积为[6.0(1.0, 17.0)%总体表面积(TBSA)]。烧伤部位以面部烧伤[(50例(40.7%)]和手部烧伤[(88例(39.0%)]为主。本组患者共有(19例(15.4%)合并吸入性损伤,7例(5.7%)接受了气管切开术。所有患者中位住院时间为10(5, 19)d,中位住ICU时间为0(0, 5)d。康复期合并畸形的有22例(17.9%)。SF-36量表得分显示,相比SF-36量表中国量化标准及评价参考值,本研究患者在躯体功能[(75.43±25.60)分]、生命活力[(48.78±12.25)分]、情感角色[(52.71±11.55)分]方面得分显示低于参照人群;IES-R量表得分显示90例(73.2%)患者表现为不同程度的应激状况,重症2例(1.7%),中症28例(22.8%),轻症60例(48.8%),亚临床33例(26.8%);SDS得分显示26例(21.1%)患者表现为不同程度的抑郁症状,重度抑郁2例(1.6%),中度抑郁8例(6.5%),轻度抑郁16例(13.0%);CBQ量表得分显示,大多数患者[(109例(88.Objective To investigate the survival of patients with small area burns after discharge,and explore the related risk factors that affect their quality of life.Methods All 123 burn patients with small area admitted to Department of Burn Surgery,First Affiliated Hospital of Naval Medical University from January 2017 to December 2018 were selected,and their demographic characteristics and burn disease related data were collected,including age,gender,education background,marital status,payment method,burn area,burn type,inhalation injury,tracheotomy,length of hospital stay and length of stay in ICU and deformity.Follow-up by telephone and short-form 36 item health survey questionnaire(SF-36)scale,selfrating depression scale(SDS),impact of event scale-revised(IES-R)scale and coping with burns questionnaire(CBQ)scale were used to investigate the patients.According to the Chinese quantitative standard and evaluation reference value of SF-36,8 aspects of SF-36 score in the study were evaluated.Spearman correlation analysis was used to explore the correlation between clinical indicators and two scoring systems(SDS score and CBQ scale score)in burns patients.The clinical indexes of burn patients were included in univariate and multivariate regression analysis to explore the independent risk factors of depression and coping ability in burn patients after discharge.Results The average age of patients with small area burns included in this study was(47.3±16.4)years old,mainly male(69.1%).The median of total burn area was[6.0(1.0,17.0)%total body surface area(TBSA)].The main burn sites were facial burns(50 cases,40.7%)and hand burns(88 cases,39.0%).There were 19 cases(15.4%)with inhalation injury,and 7 cases(5.7%)underwent tracheotomy.The median hospital stay was 10(5,19)days and the median ICU stay was 0(0,5)days.There were 22 cases(17.9%)with deformity in the stage of rehabilitation.SF-36 scale score showed that,compared with the Chinese quantitative standard and evaluation reference value of SF-36 scale,the scores of physi

关 键 词：烧伤 生活质量 危险因素 

分 类 号：R644[医药卫生—外科学]