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[中国东北地区605例化学烧伤患者的流行病学调查]

[Epidemiological investigation of 605 patients with chemical burns in northeastern China].

作者信息

Fan Hua, Liu Feng-bin, Tian Bao-xiang, Yang Xiong, Lin Hai-long, Liu Yang, Wei Chun-lin

机构信息

Department of Burns and Plastic Surgery, the General Hospital of Jilin Chemical Group Corporation, Jilin, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2012 Dec;28(6):419-22.

Abstract

OBJECTIVE

To investigate the pathogenic and clinical characteristics of chemical burns in recent years, so as to provide reference for its prevention and treatment.

METHODS

Medical records of patients with chemical burns out of 6299 burn patients admitted to our unit from January 1992 to December 2011 were screened and retrospectively analyzed, including gender, age, onset time of the injury, pre-hospital management, injury cause, injury-causing chemicals, body site of wound, burn area and depth, complications, treatment and follow-up results. The data of age distribution and incidence of complications were processed with chi-square test.

RESULTS

Investigation showed that 605 out of 6299 burn patients (accounting for 9.60%) were chemically injured. (1) Among the patients with chemical burns, the ratio of male to female was 5.11:1.00, with the mean age of 37.6 years, and the highest incidence occurred in patients aged from 20 to 29 years (29.42%, 178/605). The difference in the numbers of patients among different age groups was statistically significant (χ(2) = 207.298, P < 0.01). (2) Chemical burns mainly occurred in summer (28.43%, 172/605) and autumn (38.35%, 232/605). About 72.07% (436/605) of patients received irrigation before admission. (3) In 453 (74.88%) patients, injury occurred during industrial production. The main injury-causing chemicals were acid (46.61%, 282/605) and alkali (20.66%, 125/605), and among them the sulfuric acid accounted for the highest ratio (18.18%, 110/605). (4) The main wound positions of chemical burns were the limbs (289 patients) and the head, face, and neck region (263 patients). The mean burn area was 5.98% TBSA. The depth ranged from superficial partial-thickness to full-thickness. (5) Three hundred and forty-eight patients with chemical burns suffered common complications, including inhalation injury (154, 44.25%), ocular burns (113, 32.47%), and poisoning (81, 23.28%). There was statistically significant difference in the incidence of the three complications (χ(2) = 23.086, P < 0.01). (6) Five hundred and twenty-one patients were cured, with the cure rate of 86.12%, and 76.20% out of them healed with scars (397/521). Three patients died of poisoning, with a mortality of 0.50%.

CONCLUSIONS

The patients with chemical burns accounted for a high proportion of the burn patients admitted to our unit in the same period. The chemical burns mainly involved young males with the relatively close time of onset, and acid and alkali were the main causative factors in the process of industrial production. Most patients had the clinical features of deep wound, high incidence of complications, and liability of scar formation after wound healing.

摘要

目的

探讨近年来化学烧伤的致病及临床特点,为其防治提供参考。

方法

筛选并回顾性分析1992年1月至2011年12月我院收治的6299例烧伤患者中化学烧伤患者的病历,内容包括性别、年龄、受伤时间、院前处理、致伤原因、致伤化学物质、创面部位、烧伤面积及深度、并发症、治疗及随访结果。对年龄分布及并发症发生率的数据进行卡方检验。

结果

调查显示,6299例烧伤患者中有605例(占9.60%)为化学烧伤。(1)化学烧伤患者中,男女比例为5.11∶1.00,平均年龄37.6岁,20~29岁患者发病率最高(29.42%,178/605)。不同年龄组患者数量差异有统计学意义(χ(2)=207.298,P<0.01)。(2)化学烧伤主要发生在夏季(28.43%,172/605)和秋季(38.35%,232/605)。约72.07%(436/605)的患者在入院前接受了冲洗。(3)453例(74.88%)患者在工业生产过程中受伤。主要致伤化学物质为酸(46.61%,282/605)和碱(20.66%,125/605),其中硫酸所占比例最高(18.18%,110/605)。(4)化学烧伤的主要创面部位为四肢(289例)和头面颈部(263例)。平均烧伤面积为5.98%TBSA。深度从浅Ⅱ度到Ⅲ度。(5)348例化学烧伤患者发生常见并发症,包括吸入性损伤(154例,44.25%)、眼部烧伤(113例,32.47%)和中毒(81例,23.28%)。这三种并发症的发生率差异有统计学意义(χ(2)=23.086,P<0.01)。(6)521例患者治愈,治愈率为86.12%,其中76.20%(397/521)愈合后留有瘢痕。3例患者死于中毒,死亡率为0.50%。

结论

化学烧伤患者在同期我院收治的烧伤患者中占比高。化学烧伤主要累及年轻男性,发病时间相对集中,酸和碱是工业生产过程中的主要致病因素。多数患者具有创面深、并发症发生率高、创面愈合后易形成瘢痕的临床特点。

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