Diop-Ndoye M, Bodjona J P, Diouf E, Beye M D, Ngom G, Fall I, Ndoye M, Ka-Sall B
Departement d'Anesthésie-reanimation polyvalente, Hôpital Aristide Le Dantec, Boite postale:3001, Dakar, Sénégal.
Dakar Med. 2005;50(3):194-7.
Bums in children are serious public health problem. Burns management in developing countries encounters huge problems at any stage. The goals of this study were to descrive the epidemiological, clinical and therapeutic characterics.
In the university Teaching Hospital of Dakar from January to December 2003, we conducted a retrospective survey of 41 patients less than 16 years admitted for severe thermal burns. We carried a year retrospective study in ICU and pediatric surgery unit of Aristide Le Dantec Hospital. Were involved all. The following parameters were studied: age, sex, mechanism and circumstances of the burns, period time between the injury and the admission, clinical status of the patient, management and outcome.
The age range between 5 days and 13 years, 47.72% are less than 3 years. The average period before admission was 33 hours (2 hours to 7 days). The accident occurs in 75% of cases in the kitchen. Bum by hot water was the most frequent mechanism with a percentage of 62%. Areas interested the whole body with frequent face localisation (n=18) and the perineal region (n=22). Immediate complications were shock in 37% of children and acute respiratory failure in 7 patients. Fluids and electrolytes resuscitation using Parkland formula (75%) or Carvajal formula (25%). Feeding was done to enteral route. Spontaneous epitheliasation through secondary heeling was the main therapeutic attitude, skin grafting was performed in 10 childrens. Total mortality was 18.18%; These death concerns patients for whom the UBS score range between 75 and 140 UB and the ABSI score between 9 and 12. Sepsis was the direct main cause of death. Sequellaes were jointed a nd facial contractures.
The authors emphasize on the need in setting up adequate preventive measures towards high risk population (under 3 years), and specialized unit for adapted management.
儿童烧伤是严重的公共卫生问题。发展中国家的烧伤治疗在任何阶段都面临巨大问题。本研究的目的是描述流行病学、临床和治疗特征。
2003年1月至12月，在达喀尔大学教学医院，我们对41例16岁以下因严重热烧伤入院的患者进行了回顾性调查。我们在阿里斯蒂德·勒丹泰克医院的重症监护病房和儿科外科进行了为期一年的回顾性研究。纳入了所有患者。研究了以下参数：年龄、性别、烧伤机制和情况、受伤至入院的时间段、患者的临床状况、治疗和结果。
年龄范围在5天至13岁之间，47.72%的患者年龄小于3岁。入院前的平均时间为33小时（2小时至7天）。75%的事故发生在厨房。热水烫伤是最常见的机制，占比62%。烧伤部位累及全身，面部（n = 18）和会阴区域（n = 22）受累频繁。即时并发症包括37%的儿童发生休克，7例患者发生急性呼吸衰竭。采用帕克兰公式（75%）或卡瓦哈尔公式（25%）进行液体和电解质复苏。通过肠内途径进行喂养。通过二期愈合实现自发上皮化是主要的治疗方式，10名儿童进行了皮肤移植。总死亡率为18.18%；这些死亡患者的UBS评分在75至140 UB之间，ABSI评分在9至12之间。脓毒症是直接的主要死亡原因。后遗症包括关节和面部挛缩。
作者强调需要针对高危人群（3岁以下）制定适当的预防措施，并设立专门的科室进行适应性管理。
