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小儿电击伤:38例连续病例回顾

Pediatric electrical injuries: a review of 38 consecutive patients.

作者信息

Celik Ahmet, Ergün Orkan, Ozok Geylani

机构信息

Department of Pediatric Surgery, Ege University Faculty of Medicine, Izmir, Turkey.

出版信息

J Pediatr Surg. 2004 Aug;39(8):1233-7. doi: 10.1016/j.jpedsurg.2004.04.004.

Abstract

BACKGROUND/PURPOSE: The aim of this study was to explore the mechanisms, complications, morbidity, and mortality associated with electrical injuries in children.

METHODS

The charts of pediatric patients who had been admitted to the authors' center with electrical burn injuries (EBI) between January 1993 and October 2002 were reviewed retrospectively.

RESULTS

Of the 764 acute burn admissions over a 9-year period, 5% (38 patients) had EBI. Mean age was 9.6 +/- 4.4 years (range, 1 to 16 years). Seventy-six percent of the EBI patients were boys (M to F, 29:9), and the extent of the burn wounds ranged from 1% to 50% of total body surface area (TBSA; mean, 18.6% +/- 14.7%). High-voltage (HV) electricity accounted for 63% of the EBI (1 lightning), and 37% were caused by low-voltage (LV) current. In 19 children, serious high-voltage injuries occurred by direct contact with outlet electrical transfer wires with a metal from a balcony or with manual contact while climbing to the pole. A total of 153 surgical procedures were performed on the EBI patients, and 26% of the cases (10 of 38) required amputations. Patients who sustained HV electrical injuries had associated major complications. All of the patients underwent close cardiac monitoring, and none had cardiac complications. The average hospital stay was 23.8 +/- 14.2 (range, 2 to 48) days. One patient died of wound sepsis.

CONCLUSIONS

Although not frequent, EBI remain a serious problem, particularly in adolescent boys, and short- and long-term morbidity are significant. HV injuries occur mainly in the adolescent population and require more aggressive care. Balcony injury is a specific etiology for EBI, and special consideration is required to prevent this type of injury in our country.

摘要

背景/目的:本研究旨在探讨儿童电损伤相关的机制、并发症、发病率和死亡率。

方法

回顾性分析1993年1月至2002年10月间入住作者所在中心的小儿电烧伤患者的病历。

结果

在9年期间的764例急性烧伤入院患者中,5%(38例)为电烧伤。平均年龄为9.6±4.4岁(范围1至16岁)。电烧伤患者中76%为男性(男:女为29:9),烧伤创面面积占总体表面积(TBSA)的1%至50%(平均为18.6%±14.7%)。高压电导致的电烧伤占63%(1例雷击),37%由低压电流引起。19名儿童因直接接触阳台带有金属的插座电线或攀爬电线杆时手动接触而发生严重高压电损伤。电烧伤患者共接受了153次外科手术,26%的病例(38例中的10例)需要截肢。遭受高压电损伤的患者伴有主要并发症。所有患者均接受密切心脏监测,无一例发生心脏并发症。平均住院时间为23.8±14.2天(范围2至48天)。1例患者死于伤口脓毒症。

结论

尽管电烧伤并不常见,但仍是一个严重问题,尤其是在青春期男孩中,其短期和长期发病率都很高。高压电损伤主要发生在青少年人群中,需要更积极的治疗。阳台损伤是电烧伤的一种特殊病因,在我国预防此类损伤需要特别关注。

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