烧伤患儿329例流行病学调查及全身炎症反应综合征危险因素分析  

Epidemiological Investigation and Risk Factors Analysis of Systemic Inflammatory Response Syndrome in 329 Children with Burn

作　　者：王若宇 陈伟[1] 许勋 曹文德[1] 缪玉兰[1] WANG Ruoyu;CHEN Wei;XU Xun;CAO Wende;MIAO Yulan(Burn Research Institute,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China)

机构地区：[1]昆明医科大学第二附属医院烧伤研究所,云南昆明650032

出　　处：《昆明医科大学学报》2024年第5期123-129,共7页Journal of Kunming Medical University

基　　金：云南省卫生科技计划基金资助项目(2016NS269)。

摘　　要：目的探究烧伤患儿临床流行病学特征及发生全身炎症反应综合征(systemic inflammatory response syndrome,SISR)危险因素,为SIRS早期诊断及预防提供参考。方法昆明医科大学第二附属医院烧伤科2020年1月至2022年12月收治入院符合纳入标准的烧伤患儿329例,以病例对照的方法回顾性分析其临床资料。统计患儿年龄、性别、致伤原因、受伤季节、烧伤总面积、Ⅲ度烧伤面积、院前急救方式,入院首次血清学检查:超敏C反应蛋白(c-reactionProtein,CRP)、白细胞介素-6(interleukin-6,IL-6)、降钙素原(procalcitonin,PCT)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin,APTT)、凝血酶时间(thrombin time,TT)、纤维蛋白原(fipinogen,FIB)、D-二聚体(D-dimer,DD)及血糖水平。根据改良全身炎症反应综合征评分标准,将患儿分为SIRS组150例和非SIRS组179例,进行流行病学调查并分析筛选烧伤患儿发生SIRS的危险因素。结果(1)≥2岁且<6岁年龄组患儿烧伤发生率最高,各年龄组患儿性别构成比分析,差异无统计学意义(χ^(2)=3.480,P=0.326);(2)中度烧伤患儿最多,共217例(65.9%)。各年龄组患儿烧伤程度构成比分析,差异有统计学意义(χ^(2)=10.841,P<0.05);(3)热液烫伤患儿最多,共277例(84.2%)。对各年龄分组患儿与致伤因素构成比分析,差异有统计学意义(H=49.144,P<0.05);(4)患儿冬季烧伤发生率30.39%(100/329),高于其他季节。不同年份烧伤患儿受伤季节分布构成比分析,差异具有统计学意义(χ^(2)=25.390,P<0.05);(5)烧伤患儿烧伤后近半数未进行处理,占46.8%。其次是进行不当处理,占38%。正确处理病例数仅有50例,占15.2%;伤后入院时间≤8 h组病例数占半数以上,占66.3%,其次是>12 h且≤24 h,占15.2%。而>24 h且≤72 h占比最低,仅占8.8%;(6)筛选出烧伤指数、血糖水平、超敏C反应蛋白、白细胞介素-6、降钙素原、凝血酶原时间(P均<Objective To explore the clinical epidemiological characteristics and risk factors of systemic inflammatory response syndrome(SIRS)in children with burns,so as to provide a reference for the early diagnosis and prevention of SIRS.Methods A retrospective analysis of the clinical data of 329 children with burns who were admitted to the Burn Department of the Second Affiliated Hospital of Kunming Medical University from January 2020 to December 2022 and met the inclusion criteria was conducted using a case-control method.The age,gender,cause of injury,season of injury,total burn area,area of third-degree burns,pre-hospital first aid methods,and first serum examination upon admission of the children were statistically analyzed.The serum markers encompassed C-reactive protein(CRP),Interleukin-6(IL-6),procalcitonin(PCT),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer(DD),and blood glucose level.According to the modified SIRS scoring criteria,the children were divided into a SIRS group(150 cases)and a non-SIRS group(179 cases).An epidemiological survey was conducted and the risk factors for the occurrence of SIRS in children with burns were analyzed.Results(1)The incidence of burns in children aged≥2 and<6 years was the highest in this study.The gender composition ratio of children in each age group was analyzed,and the difference was not statistically significant(χ^(2)=3.480,P=0.326).(2)Moderate burns were the most common,accounting for 217 cases(65.9%).The difference in the degree of burns among age groups was statistically significant(χ^(2)=10.841,P<0.05).(3)There were 277 cases of hot liquid burns(84.2%).The composition ratio of the cause of injury in children of different age groups was analyzed,and the difference was statistically significant(H=49.144,P<0.05).(4)The incidence of burns in children in winter was 30.39%(100/329),which was higher than in other seasons.The distribution of the season of injury in children with burns in different years was an

关 键 词：烧伤 儿童 全身炎症反应综合征 流行病学 

分 类 号：R644[医药卫生—外科学]