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[14岁以下大面积烧伤患儿的流行病学调查:一项多中心研究]

[An epidemiological investigation of pediatric patients under 14 with large area burns: a multicenter study].

作者信息

Cheng W F, Zhao D X, Shen Z A, Zhang H Y, Tu J J, Yuan Z Q, Duan P, Song G D

机构信息

Department of Burn and Plastic Surgery, Burn Institute, the First Hospital Affiliated to the PLA General Hospital, Beijing 100048, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2017 Feb 14;97(6):462-467. doi: 10.3760/cma.j.issn.0376-2491.2017.06.013.

Abstract

To investigate and evaluate the epidemiological characteristics of patients under 14 with large area burns in China. Data of pediatric patients aged 0-14yr with ≥30% total body surface area (TBSA) burned admitted into 106 burn centers in the mainland of China in 2014 were retrieved. The children were divided into three age groups: 0-3, 4-6 and 7-14 years according to the age. Information of age, gender, time of burn injury, causes of burns, admission time, prehospital emergency care of burn wound, burn area, inhalation injuries, the case fatality rate and length of hospital stay were collected for analysis. Of the 486 cases included, 285 (58.6%) were boys and 201 (41.4%) were girls. The mean age of the children was (3.4±2.8) years. Children under 3 years old accounted for 67.5% of all the cases. 271 of the burn injuries (55.8%) occurred from April through August. Scalds and flames were the main causes of burns, which were the causes of 394 cases (81.1%) and 71 cases (14.6%), respectively. The burn injuries resulted from scalds and flames accounted for 89.6% and 7.3%, 70.8% and 21.9%, 51.6% and 41.9% in the age group of 0-3, 4-6 and 7-14 years respectively. The distribution of burn etiology in different age groups differed significantly (χ(2)=21.239, 59.442, 7.333, all <0.01). Most of the patients (57.8%) were admitted within 2 hours after injury. However, when it came to the pre-hospital emergency management of burn wound, 164 patients (33.7%) did not use any drug or wound dressing, whereas the wound area of 236 patients (48.6%) were treated improperly with toothpaste, soy sauce, eggs or other non-standard disposal. The mean TBSA area of the patients was (42.1±14.5)%, while 288 (59.3%) of the patients suffered full thickness burns with mean TBSA of (24.5±17.9)%. The case fatality rate (CFR) was 4.1%, and the CFR of patients complicated with inhalation injury was significantly higher than those without (<0.01). The average length of stay for pediatric burn patients was (52.3±40.2) days. Children under 3 years old are important target population of severe burns. Scald is the most common type of burns, while the proportion of flames increases as age goes up. Most patients are likely to get clinical treatment in time, however, the pre-hospital emergency burn care is not satisfying at present.

摘要

调查和评估中国14岁以下大面积烧伤患者的流行病学特征。检索2014年中国大陆106家烧伤中心收治的0 - 14岁、烧伤总面积(TBSA)≥30%的儿科患者数据。根据年龄将儿童分为三个年龄组:0 - 3岁、4 - 6岁和7 - 14岁。收集年龄、性别、烧伤时间、烧伤原因、入院时间、院前烧伤创面急救处理、烧伤面积、吸入性损伤、病死率和住院时间等信息进行分析。纳入的486例患者中,男285例(58.6%),女201例(41.4%)。儿童平均年龄为(3.4±2.8)岁。3岁以下儿童占所有病例的67.5%。271例烧伤(55.8%)发生在4月至8月。烫伤和火焰伤是烧伤的主要原因,分别为394例(81.1%)和71例(14.6%)。0 - 3岁、4 - 6岁和7 - 14岁年龄组中,因烫伤和火焰伤导致的烧伤分别占89.6%和7.3%、70.8%和21.9%、51.6%和41.9%。不同年龄组烧伤病因分布差异有统计学意义(χ(2)=21.239、59.442、7.333,均<0.01)。大多数患者(57.8%)在受伤后2小时内入院。然而,在院前烧伤创面急救处理方面,164例患者(33.7%)未使用任何药物或伤口敷料,23

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