儿童烧伤病因及临床特点对预后影响的倾向加权分析  

Influence of etiology and clinical characteristics on prognosis of burn in children with propensity weighted analysis

作　　者：姜海洋 杨洪 马常明 JIANG Hai-yang;YANG Hong;MA Chang-ming(Burn Department and Severe Burn Ward of Nanyang Nanshi Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳南石医院烧伤科及烧伤重症病区,河南南阳473000

出　　处：《医药论坛杂志》2024年第12期1300-1304,共5页Journal of Medical Forum

摘　　要：目的通过倾向加权分析儿童烧伤病因及临床特点对预后的影响。方法选取南阳南石医院2021年1月至2023年7月诊治的儿童烧伤患者107例,按烧伤病因分为烫伤烧伤组75例和火焰烧伤组32例。收集患儿人口学、临床资料及住院期间预后情况。使用逆概率加权平衡两组临床资料减少偏差,logistic回归确定烧伤病因对住院期间不良预后的影响。结果火焰烧伤组患儿年龄、烧伤面积、烧伤至入院时间均高于烫伤烧伤组。火焰烧伤组抗生素治疗、手术治疗和住院时间均高于烫伤烧伤组。住院期间预后结果显示,火焰烧伤组未治愈、脓毒症和死亡比率均高于烫伤烧伤组。加权logistic回归后两组基于烧伤病因的协变量比较差异无统计学意义。倾向评分加权logistic回归调整后模型显示,火焰烧伤和较高的烧伤面积增加了住院期间不良预后风险,接受手术治疗和年龄较大降低了住院期间不良预后风险。结论火焰烧伤和烫伤烧伤在炎症反应、治疗时间和住院结局方面存在差异,应根据这些差异开发针对性治疗方法,预防代谢功能障碍并改善临床结局。Objective To analyze the influence of etiology and clinical characteristics on prognosis of burn in children by propensity weighting.Methods Totally 107 pediatric burn patients diagnosed and treated in Nanyang Nanshi Hospital from January 2021 to July 2023 were divided into scald burn group(75 cases)and flame burn group(32 cases)according to the cause of burn.Demographic and clinical data and prognosis during hospitalization were collected.Inverse probability weighting was used to balance clinical data between the two groups to reduce bias,and logistic regression was used to determine the influence of burn etiology on poor prognosis during hospitalization.Results The age,burn area and time from burn to hospital admission of children in flame burn group were higher than those in scald burn group.The duration of antibiotic treatment,surgical treatment and hospital stay in the flame burn group were higher than those in the scald burn group.Prognosis during hospitalization showed that flame burn group had higher rates of uncured,sepsis and death than scald burn group.After weighted logistic regression,there was no significant difference in covariates between the two groups based on the cause of burn.Propensity score weighted logistic regression adjusted models showed that flame burns and higher burn area increased the risk of poor prognosis during hospitalization,while receiving surgery and being older decreased the risk of poor prognosis during hospitalization.Conclusion Flame burn and scald burn have differences in inflammatory response,treatment time and hospitalization outcomes,and targeted treatment should be developed according to these differences to prevent metabolic dysfunction and improve clinical outcomes.

关 键 词：火焰烧伤 烫伤烧伤 倾向性加权分析 儿童 

分 类 号：R726[医药卫生—儿科]