Sheridan R L, Hinson M I, Liang M H, Nackel A F, Schoenfeld D A, Ryan C M, Mulligan J L, Tompkins R G
Shriners Burns Hospital for Children, Department of Surgery, Harvard Medical School, Boston, Mass, USA.
JAMA. 2000 Jan 5;283(1):69-73. doi: 10.1001/jama.283.1.69.
Major advances in treatment of burn injuries in the last 20 years have made it possible to save the lives of children with massive burns, but whether their survival comes at the cost of impaired quality of life is unknown.
To investigate the long-term quality of life in children who have survived massive burns.
Retrospective, cross-sectional study conducted in a regional pediatric burn center.
Eighty subjects who were younger than 18 years at the time of injury, who survived massive burns involving > or =70% of the body surface, and who were admitted to the burn center between 1969 and 1992 were evaluated an average (SD) of 14.7 (6.0) years after injury.
Short Form 36 (SF-36) scores of the 60 patients aged at least 14 years were compared with national norms and the impact of clinical variables on individual domain scores was assessed.
The SF-36 domain scores of the study patients, who had survived massive burns at a mean (SD) age of 8.8 (5.5) years, were generally similar to the normal population). However, 15% and 20% of the burn patients had scores in the physical functioning and physical role domains, respectively, that were more than 2 SDs below the relevant norm, indicating that a few patients had continuing serious physical disability. Better functional status of the family predicted a higher score in physical role (P = .04). The child's early reintegration with preburn activities predicted higher scores in general health (P = .03), physical functioning (P = .003), and physical role (P = .01). Children followed up consistently in the multidisciplinary burn clinic for 2 years had higher physical functioning (P = .04).
In this study, while some children surviving severe burns had lingering physical disability, most had a satisfying quality of life. Comprehensive burn care that included experienced multidisciplinary aftercare played an important role in recovery.
过去20年里烧伤治疗取得了重大进展，这使得挽救大面积烧伤儿童的生命成为可能，但他们的存活是否是以生活质量受损为代价尚不清楚。
调查大面积烧伤存活儿童的长期生活质量。
在一家地区性儿科烧伤中心进行的回顾性横断面研究。
80名在受伤时年龄小于18岁、存活于大面积烧伤（体表面积≥70%）且于1969年至1992年间入住该烧伤中心的受试者，在受伤后平均（标准差）14.7（6.0）年接受评估。
将60名年龄至少14岁患者的简明健康状况调查问卷（SF - 36）评分与全国常模进行比较，并评估临床变量对各个领域评分的影响。
这些研究患者平均（标准差）在8.8（5.5）岁时经历大面积烧伤后存活，其SF - 36领域评分总体上与正常人群相似。然而，分别有15%和20%的烧伤患者在身体功能和身体角色领域的评分比相关常模低超过2个标准差，表明少数患者仍存在严重身体残疾。家庭功能状态较好预示着身体角色领域得分较高（P = 0.04）。儿童早期重新参与伤前活动预示着在总体健康（P = 0.03）、身体功能（P = 0.003）和身体角色（P = 0.01）领域得分较高。在多学科烧伤诊所持续随访2年的儿童身体功能较好（P = 0.04）。
在本研究中，虽然一些严重烧伤存活儿童存在持续的身体残疾，但大多数人的生活质量令人满意。包括经验丰富的多学科后续护理在内的综合烧伤护理在康复中发挥了重要作用。
