Pham Tam N, King Jennifer R, Palmieri Tina L, Greenhalgh David G
Burn Surgery, Shriners Hospitals for Children, Northern California 95817, USA.
J Burn Care Rehabil. 2003 Jul-Aug;24(4):223-7. doi: 10.1097/01.BCR.0000075970.36430.7F.
Self-inflicted burn injuries, although uncommon, are a significant source of morbidity and mortality. The purpose of this study was to delineate the characteristics of these burns and to examine their impact on society. Records of 32 adult patients admitted for self-inflicted burns at our regional burn center between January 1996 and August 2001 were retrospectively reviewed. The mean burn size was 34 +/- 29% TBSA, with the majority of burns being the result of self-immolation using a flammable liquid. There was a slight male predominance (59%) and a significant mortality rate (25%). Ninety-one percent of patients had an active psychiatric diagnosis, with 47% having had a previous suicide attempt. Two thirds had a chronic stressor, such as a chronic medical illness and/or long-term disability. Only four patients had private insurance, whereas the remainder relied on underfunded state- and county-sponsored programs or were uninsured. In addition to well-described psychiatric factors, common characteristics predisposing to self-inflicted burns include chronic medical illnesses, long-term disability, and a lack of access to adequate mental health care. Better treatment of mental illness in the underfunded population might ultimately save the high costs of these burn injuries.
自我烧伤，虽然不常见，但却是发病和死亡的一个重要原因。本研究的目的是描述这些烧伤的特征，并探讨它们对社会的影响。对1996年1月至2001年8月间在我们地区烧伤中心住院的32例成年自我烧伤患者的记录进行了回顾性研究。平均烧伤面积为34±29%TBSA，大多数烧伤是使用易燃液体自焚所致。男性略占优势（59%），死亡率较高（25%）。91%的患者有活跃的精神疾病诊断，47%曾有过自杀未遂。三分之二的患者有慢性应激源，如慢性疾病和/或长期残疾。只有4例患者有私人保险，其余患者依赖资金不足的州和县资助项目或未参保。除了已充分描述的精神因素外，易导致自我烧伤的常见特征包括慢性疾病、长期残疾以及缺乏足够的心理健康护理。在资金不足的人群中更好地治疗精神疾病可能最终节省这些烧伤的高昂费用。
