Bang R L, Sharma P N, Bang S, Mokaddas E M, Ebrahim M K, Ghoneim I E
Al Babtain Centre for Plastic Surgery and Burns, Faculty of Medicine, Kuwait University, Kuwait.
Ann Burns Fire Disasters. 2007 Jun 30;20(2):62-8.
One hundred and sixty burn patients suffering from septicaemia, hospitalized in the Al-Babtain Centre burns unit, Kuwait, between June 1992 and May 2001, were studied. Thirty-two patients (20%) had scalds and 128 (80%) flame burns, thus representing a ratio of 1:4 among septicaemic patients. There were 20 males (62.5%) in the scald group, compared to 73 (57%) with flame burns. Flame burns were significantly higher (p < 0.01) among non-Kuwaiti patients. The mean ages of the scald and flame burn patients were respectively 6.2 and 31.5 yr. The mean total body surface area burn in scalds was 20% and in flame burns 49%, which was significantly higher (p < 0.001). The 34 septicaemic episodes in 32 scald patients and 212 such episodes in 128 flame burn patients showed a significantly higher incidence in the latter group. The majority of septicaemic episodes, in scalds (82.4%) and flame burns (57.6%), were due to gram-positive organisms, mainly methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis. A significantly increased number of episodes were due to S. aureus (p < 0.001) and Enterococcus (p < 0.05) in scald patients. More surgical operations were performed in flame burn patients and survival increased significantly with an increasing number of grafting sessions (p < 0.001). The mean hospital stay in flame burn patients (56 days) was significantly higher than in scald patients (23 days) (p < 0.001). It is significant to record that all the 38 deaths (29.7%) were in flame burn septicaemic patients (p < 0.001). The scald and flame burn patients were quite distinct in their demographic and clinical characteristics. The flame burn patients were more vulnerable to septicaemia, with a high risk of mortality.
对1992年6月至2001年5月间在科威特Al-Babtain中心烧伤科住院的160例烧伤合并败血症患者进行了研究。32例患者（20%）为烫伤，128例（80%）为火焰烧伤，在败血症患者中二者比例为1:4。烫伤组有20名男性（62.5%），火焰烧伤组有73名男性（57%）。非科威特患者中火焰烧伤的比例显著更高（p<0.01）。烫伤和火焰烧伤患者的平均年龄分别为6.2岁和31.5岁。烫伤患者的平均烧伤总面积为20%，火焰烧伤患者为49%，后者显著更高（p<0.001）。32例烫伤患者中有34次败血症发作，128例火焰烧伤患者中有212次败血症发作，后一组的发病率显著更高。大多数败血症发作，烫伤患者中为82.4%，火焰烧伤患者中为57.6%，是由革兰氏阳性菌引起的，主要是耐甲氧西林金黄色葡萄球菌和耐甲氧西林表皮葡萄球菌。烫伤患者中由金黄色葡萄球菌（p<0.001）和肠球菌（p<0.05）引起的发作次数显著增加。火焰烧伤患者接受的手术更多，随着植皮次数的增加生存率显著提高（p<0.001）。火焰烧伤患者的平均住院时间（56天）显著长于烫伤患者（23天）（p<0.001）。值得注意的是，所有38例死亡患者（29.7%）均为火焰烧伤合并败血症患者（p<0.001）。烫伤和火焰烧伤患者在人口统计学和临床特征上有很大差异。火焰烧伤患者更容易发生败血症，死亡风险高。
