Brandt Christopher P, Yowler Charles J, Fratianne Richard B
Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109-1998, USA.
Am Surg. 2002 Mar;68(3):240-3; discussion 243-4.
The purpose of this study was to determine the incidence, mechanisms, and outcomes of management in patients with multisystem trauma and associated burn injury. A retrospective review was performed of patients admitted with combined burns and trauma from 1990 through 1999. Mechanism of injury, extent of burns, associated injuries, Injury Severity Score (ISS), and patient outcomes were identified. There were 2,845 burn and 19,418 trauma admissions. Fifty-six patients (2.0% and 0.29% respectively) had combined burns and trauma. Mean ISS was 21.7 and average percentage total body surface area was 16.2. Associated injuries included fractures in 32, complex soft-tissue injury in 20, head injury in 11, and abdominal trauma in seven. Mechanism of injury was industrial in 19, motor vehicle accident in 16, house fire in 13, high voltage in six, and other in three. Skin grafting was required in 33 of 56 patients (59%). Six of 56 patients died. Mean ISS was 19.0 in survivors compared with 46.2 in nonsurvivors. The combination of burns with multiple system trauma is uncommon. Fractures are the most frequent associated injury, and the majority of patients will require skin grafting in their burn treatment. Outcomes with appropriate management are favorable and are primarily dependent on the degree of associated trauma.
本研究的目的是确定多发伤合并烧伤患者的发病率、损伤机制及治疗结果。对1990年至1999年收治的烧伤合并创伤患者进行回顾性研究。确定损伤机制、烧伤程度、合并伤、损伤严重度评分（ISS）及患者治疗结果。烧伤入院患者2845例，创伤入院患者19418例。56例患者（分别占2.0%和0.29%）合并烧伤和创伤。平均ISS为21.7，平均烧伤总面积百分比为16.2。合并伤包括骨折32例、复杂软组织损伤20例、头部损伤11例、腹部创伤7例。损伤机制为工业伤19例、机动车事故16例、房屋火灾13例、高压伤6例、其他3例。56例患者中有33例（59%）需要植皮。56例患者中有6例死亡。幸存者的平均ISS为19.0，非幸存者为46.2。烧伤合并多系统创伤并不常见。骨折是最常见的合并伤，大多数患者在烧伤治疗中需要植皮。适当治疗后的结果良好，主要取决于合并创伤的程度。
