498例成人特重度烧伤患者的临床资料分析  

Analysis of the Clinical Data of 498 Adult Patients with Particularly Severe Burns

作　　者：张梓晨 陈伟[1] 郑舒芩 陈宗华[1] 江河[1] 缪玉兰[1] ZHANG Zichen;CHEN Wei;ZHENG Shuqin;CHEN Zonghua;JIANG He;MIAO Yulan(Burn Research Institute,The Second Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院烧伤科,云南昆明650101

出　　处：《昆明医科大学学报》2022年第10期90-97,共8页Journal of Kunming Medical University

基　　金：云南省卫生科技计划项目(2016NS269)。

摘　　要：目的分析498例成人特重度烧伤患者的临床特点。方法回顾性分析昆明医科大学第二附属医院2016年1月至2020年12月符合入选标准的498例特重度烧伤患者病历资料,对其性别、年龄、职业、烧伤原因、烧伤面积、烧伤深度、院前处理、急诊就医地点、并发症、是否手术治疗、治疗转归、住院时间、住院费用、医疗付费方式等进行统计分析。对数据进行χ^(2)检验、Mann-Whitney U检验、Kruskal-Wallis H检验、Fisher确切概率法分析、Binary Logistic回归分析。结果笔者单位5 a间共收治6023例烧伤住院患者,其中498例(8.27%)为符合入选标准的成人特重度烧伤。(1)受伤原因以热力烧伤为主,共462例(92.77%),其中火焰烧伤最多,为367例;男性明显多于女性(χ^(2)=155.189,P<0.001);受伤人群集中在青年组,为289例(58.03%);居住地农村多于城市,分布差异明显(χ^(2)=33.936,P<0.001);职业主要为农民(251例,50.40%)与工人(121例24.30%)。(2)受伤后创面予以冷水冲洗62例(12.45%),未予冷水冲洗436例(87.55%),创面经冷水冲洗患者的好转治愈率(77.42%)高于未冲洗患者(68.81%),死亡率低于未冲洗患者(6.45%<10.32%)。(3)合并并发症340例次,前5位是吸入性损伤(56.18%)、低血容量性休克(26.47%)、低蛋白血症(18.24%)、肺部感染(17.35%)、脓毒症(12.06%),死亡的主要原因是吸入性损伤和脓毒症最终导致的多器官功能衰竭。(4)手术治疗320例(64.26%),未手术治疗178例(35.74%);治愈好转348例(69.88%),死亡49例(9.84%),自动出院101例(20.28%),不同治疗方式转归差异明显(Ζ=−8.310,P<0.001)。(5)总体平均住院日为36(15,62)d。人均住院总费用为:140740.2250元。付费方式以自费335例(67.27%)占比最高。(6)各类因素经多重线性回归方程检验得出年龄、性别、烧伤总面积、Ⅲ°烧伤面积、有无并发症、住院时间长短对特重度烧伤患者转归有影响,差异均有统计学意义(P<0.05)。结论�Objective To analyze the clinical characteristics of 498 adult patients with particularly severe burns.Methods We made a retrospective analysis of the medical records of the second affiliated hospital of Kunming medical university in January 2016 December 2020498 cases with inclusion criteria,the gender,age,occupation,burn cause,burn area,burn depth,depth of hospital treatment,emergency treatment,compound injury,complications,surgical treatment,treatment,hospital time,hospital costs,medical payment.The data were performedχ^(2) test,Mann-Whitney U test,Kruskal-Wallis H test,Fisher exact probability method analysis,and Binary Logistic regression analys is).Results A total of 6,023 hospitalized burn patients were admitted during the past five years,of which 498 patients(8.27%)were adults with particularly severe burns who met the inclusion criteria.(1)injuries were mainly caused by 462(92.77%),with the most in 367;significantly more men than women(χ^(2)=155.189,P<0.001);concentrated in youth group,289(58.03%),more in rural areas than cities(χ^(2)=33.936,P<0.001);occupation mainly farmers(251 cases,50.40%)and workers(121,24.30%).(2)After injury,62 patients(12.45%)and 436 patients(87.55%)were not washed with cold water.The cure rate of patients with cold water washing was higher than that of unwashed patients,and the mortality rate was lower than that of unwashed patients.(3)With 340 complications,the top five were inhalation injury(56.18%),hypovolemic shock(26.47%),hypoproteinemia(18.24%),pulmonary infection(17.35%),and sepsis(12.06%).The main causes of death were mostly inhalation injury and sepsis and multiple organ failure.(4)treated 320(64.26%),178(35.74%);348(69.88%),49(9.84%),101(20.28%),and different treatment methods(Ζ=−8.310,P<0.001).(5)The overall average of hospital stay was 36(15,62)d.The total hospitalization cost per capita is:140,740.2250 yuan.The highest payment method was in 335 cases(67.27%).(6)In age,sex,total burn area,Ⅲ burn area,presence of complications,and length of hospitalization aff

关 键 词：特重度烧伤 特点 分析 

分 类 号：R644[医药卫生—外科学]