体内液态塑料和液态金属异物烧冲复合伤患者的比较研究  

Comparative study on patients with combined burn-blast injuries caused by liquid plastic and liquid metal foreign objects in the body

作　　者：柯家祥[1] 于风格 李宁[1] 边曦[1] 邓若梅子 李蓓[1] Ke Jiaxiang;Yu Fengge;Li Ning;Bian Xi;Deng Ruomeizi;Li Bei(Department of Burns and Plastic Surgery,Qingdao Hospital of Rehabilitation University(Qingdao Municipal Hospital),Qingdao266011,China;Department of Burns and Plastic Surgery,Qingdao Jimo District Emergency Center,Qingdao266200,China)

机构地区：[1]康复大学青岛医院(青岛市市立医院)烧伤整形科,青岛266011 [2]青岛市即墨区急救中心烧伤整形科,青岛266200

出　　处：《中华烧伤与创面修复杂志》2024年第11期1059-1065,共7页Chinese Journal of Burns And Wounds

摘　　要：目的比较体内液态塑料和液态金属异物烧冲复合伤患者的临床特点、诊断方案、治疗策略等。方法该研究为回顾性队列研究。2009年1月—2019年7月,康复大学青岛医院烧伤整形科收治41例符合入选标准的热溶液爆炸导致的烧冲复合伤患者。统计所有患者的性别、年龄、烧伤总面积、伤后入院时间、烧冲复合伤发生部位、体内异物类型。根据体内异物类型将患者分为液态塑料组(30例)和液态金属组(11例)。统计2组患者临床特点(受伤部位肿胀情况、疼痛情况、发热情况、脓肿形成情况、损伤深度、异物活动度、异物剥离难易程度)、影像学检查(超声、计算机X线摄影、CT、磁共振成像检查)情况、治疗情况(修复时期、修复方式)及出院后随访时并发症发生情况。结果患者中男33例、女8例,年龄18~65岁,烧伤总面积为1%~78%体表总面积,伤后入院时间为2 h~7 d,烧冲复合伤主要发生在四肢及躯干,体内异物为液态塑料(聚乙烯和丙烯腈丁二烯苯乙烯)和液态金属(液态铁和铝)。液态塑料组患者受伤部位肿胀、损伤深及骨、异物活动度差、异物剥离困难的比例均明显高于液态金属组(P<0.05)。液态金属组患者通过计算机X线摄影、CT检查明确体内异物的比例分别为7/7、8/8,均明显高于液态塑料组的1/5、3/20(P<0.05);液态金属组患者通过超声检查明确体内异物的比例为11/11,与液态塑料组的24/26相近(P>0.05);液态金属组患者通过磁共振成像检查明确体内异物的比例为2/2,与液态塑料组的4/4相同。液态塑料组患者行创面Ⅰ期修复、直接缝合的比例均明显低于液态金属组(P<0.05),行创面延期修复、皮片移植与皮瓣移植的比例均明显高于液态金属组(P<0.05)。2组患者出院后随访时并发症发生情况均无明显差异(P>0.05)。结论烧冲复合伤患者因体内异物类型、存在部位不同,受损严重程度也不同ObjectiveTo compare the clinical characteristics,diagnostic plans,and treatment strategies of patients with combined burn-blast injuries caused by liquid plastic and liquid metal foreign objects in the body.MethodsThis study was a retrospective cohort study.From January 2009 to July 2019,41 patients with combined burn-blast injuries caused by hot solution explosion who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of Qingdao Hospital of Rehabilitation University.The following indexes of all patients were collected,including gender,age,total burn area,admission time after injury,site of combined burn-blast injuries,and type of foreign objects in the body.According to the type of foreign objects in the body,the patients were divided into liquid plastic group(30 cases)and liquid metal group(11 cases).The following indexes of the two groups of patients were collected,including the clinical characteristics(swelling in the injury site,pain,fever,abscess formation,depth of injury,activity of foreign objects,and difficulty in removing foreign objects),imaging examinations(ultrasound,computed radiography,computed tomography,and magnetic resonance imaging examinations),treatment(repair period and repair method),and incidence of complications during follow-up after discharge.ResultsThere were 33 males and 8 females among the patients,aged 18-65 years.The total burn area was 1%to 78%total body surface area,the admission time after injury was 2 h to 7 d,the combined burn-blast injuries mainly occurred in the limbs and trunk,and the foreign objects in the body were liquid plastics(polyethylene and acrylonitrile butadiene styrene)and liquid metals(liquid iron and aluminum).The proportions with swelling in the injury site,injury with depth to the bone,poor mobility of foreign objects,and difficulty in removing foreign objects in patients in liquid plastic group were significantly higher than those in liquid metal group(P<0.05).The proportions of confirming foreign objects in the body thr

关 键 词：烧伤 异物 烧冲复合伤 液态塑料 液态金属 临床特征 创面修复 

分 类 号：R644[医药卫生—外科学]