229例手部氢氟酸烧伤患者的流行病学特征和治疗结局分析  

Epidemiological characteristics and treatment outcome analysis of 229 patients with hydrofluoric acid burns in hands

作　　者：张曼佳 毛书雷 张建芬[2] 王新刚[3] 倪良方 张元海[2] Zhang Manjia;Mao Shulei;Zhang Jianfen;Wang Xingang;Ni Liangfang;Zhang Yuanhai(The First Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Burns and Plastic Surgery,Zhejiang Quhua Hospital,Quzhou 324004,China;Department of Burn and Wound Repair,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053 [2]浙江衢化医院烧伤整形科,衢州324004 [3]浙江大学医学院附属第二医院烧伤与创面修复科,杭州310009

出　　处：《中华烧伤与创面修复杂志》2022年第2期156-164,共9页Chinese Journal of Burns And Wounds

基　　金：国家重点研发计划(2018YFC0808600);浙江省公益技术应用研究计划(2017C33186)。

摘　　要：目的探讨手部氢氟酸烧伤患者的流行病学特征及治疗结局。方法采用回顾性观察性研究方法。收集浙江衢化医院2008年1月—2020年12月收治的符合入选标准的229例手部氢氟酸烧伤患者的病历资料,统计患者的性别、年龄、所在企业类型、氢氟酸质量分数、烧伤部位、烧伤总面积、院前时间、住院天数、创面愈合天数、入院时是否有低钙血症和低镁血症、是否行手术治疗、有无瘢痕后遗症。采用单因素和多因素logistic回归分析筛选影响全部患者和氢氟酸质量分数已知的患者手术治疗和瘢痕后遗症的危险因素,采用单因素和多因素线性回归分析筛选影响全部患者和氢氟酸质量分数已知的患者创面愈合天数的危险因素。结果229例患者中男206例、女23例,年龄主要集中在30~50岁(139例),大部分患者的所在企业类型为非氟化工企业,仅91例患者的致伤氢氟酸质量分数已知(以中质量分数为主),常见的烧伤部位为手指中末节,烧伤总面积均≤1%体表总面积,院前时间为19(9,29)h,住院天数为2(1,7)d,创面愈合天数为12(8,18)d,入院时有低钙血症、低镁血症的比例分别为0.9%(2/229)、1.3%(3/229),36例患者行手术治疗,83例患者有瘢痕后遗症。针对229例患者,单因素logistic回归分析显示,所在企业类型、院前时间均是患者手术治疗(比值比分别为7.86、51.35,95%置信区间分别为1.83~33.76、11.89~221.78,P<0.01)和瘢痕后遗症(比值比分别为3.62、27.40,95%置信区间分别为1.76~7.43、13.25~56.68,P<0.01)的影响因素;多因素logistic回归分析显示,院前时间是影响患者手术治疗和瘢痕后遗症的独立危险因素(比值比分别为43.00、24.55,95%置信区间分别为9.89~187.03、11.78~51.16,P<0.01);单因素线性回归分析显示,所在企业类型、院前时间均是患者创面愈合天数的影响因素(β值分别为6.16、12.83,95%置信区间分别为3.38~8.93、10.72~14.93,P<0.01);Objective To explore the epidemiological characteristics and treatment outcomes of patients with hydrofluoric acid burns in hands.Methods A retrospective observational study was conducted.The medical records of 229 patients with hydrofluoric acid burns in hands who were admitted to Zhejiang Quhua Hospital from January 2008 to December 2020 and met the inclusion criteria were collected.The following statistical data of patients were collected,including gender,age,type of affiliated enterprise,hydrofluoric acid mass fraction,injury site,total burn area,prehospital time,length of hospital stay,length of wound healing,whether hypocalcemia and hypomagnesemia occurred or not on admission,whether surgery intervention was performed or not,and whether scar sequelae occurred or not.Single factor and multivariate logistic regression analysis were used to screen out the risk factors impacting surgery intervention and scar sequelae of all the patients and patients whose hydrofluoric acid mass fraction was known.Single factor and multivariate linear regression analysis were used to screen out the risk factors impacting the length of wound healing of all the patients and patients whose hydrofluoric acid mass fraction was known.Results The 229 patients included 206 males and 23 females,with the majority aged 30 to 50 years(139 patients).The type of affiliated enterprise of majority patients was non-fluorine chemical enterprise.The hydrofluoric acid mass fraction was known in only 91 patients,mainly medium.The majority injury site was in the middle and end of finger.The total burn area was below or equal to 1%total body surface area.The prehospital time was 19(9,29)h.The length of hospital stay was 2(1,7)d.The length of wound healing was 12(8,18)d.The proportions of hypocalcemia and hypomagnesemia were 0.9%(2/229)and 1.3%(3/229)on admission,respectively.Thirty-six patients had surgeries and 83 patients had scar sequelae.In 229 patients,single factor logistic regression analysis showed that both type of affiliated enterprise and p

关 键 词：烧伤 化学 氢氟酸 手 伤口愈合 危险因素 

分 类 号：R644[医药卫生—外科学]