Jin Ronghua, Wu Pan, Ho Jon Kee, Wang Xingang, Han Chunmao
Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China.
Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China.
Burns. 2018 Feb;44(1):210-217. doi: 10.1016/j.burns.2017.05.011. Epub 2017 Aug 7.
The incidence of liquefied petroleum gas (LPG)-related burns has increased over recent years, and it has become a serious public health issue in developing countries such as India and Turkey. This paper aims to investigate the epidemiological characteristics of LPG-related burns to provide assistance and suggestions for planning prevention strategies.
A 5-year retrospective study was conducted in patients with LPG-related burns admitted to the Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, College of Medicine, between 1st January 2011 and 31st December 2015. Information obtained for each patient included age, gender, education status, occupation, medical insurance, average hospital cost, length of hospital stay, monthly distribution of incidence, place of burns, mechanism of burns, extent of burns, site of burns, accompanying injuries, and treatment outcomes.
For the first 4 years (2011-2014), the yearly incidence of LPG-related burns was at approximately 10% of all burns; however, in the fifth year (2015) alone, there was a surge to 26.94%. A total of 1337 burn patients were admitted during this period. Of these, 195 patients were admitted because of 169 LPG-related accidents; there were 11 accidents involving more than one victim. LPG-related burns occurred most frequently in patients aged 21-60 years (73.85%). The majority of injuries occurred from May to August (56.41%), and the most common place was home (83.08%, 162 patients). Gas leak (81.03%) was the main cause of LPG-related burns, followed by inappropriate operation (7.69%) and cooking negligence (2.05%). The mean burn area was 31.32±25.40% of TBSA. The most common sites of burns were the upper extremities (37.47%), followed by the head/face and neck (24.80%) and lower extremities (19.95%). The most common accompanying injuries included inhalation injury (23.59%), shock (8.71%), and external injury (7.18%). The average hospital stay was 22.90±19.47days (range 2-84 days). Only 48 patients (24.62%) had medical insurance, while 124 patients (63.59%) had no medical insurance. The average hospital cost of the no medical insurance group was significantly higher (p<0.0001) than that of the medical insurance group. In addition, 72.73% of patients who left against medical advice (LAMA) were uninsured. The number of patients who recovered at our hospital was 165 (84.62%), while 22 patients (11.28%) LAMA. The overall mortality rate was 4.10% (8 patients).
Our study shows that the exponential increase in LPG-related burns is alarming. This calls for rigorous precautions. Because gas leak was the main cause of LPG-related burns, any part of LPG stove system that shows signs of weathering should be replaced regularly. In addition, we also found that most of the LAMA patients were uninsured. Thus, comprehensive medical insurance should be involved early in the recovery process to assure a safe and adequate discharge.
近年来,液化石油气(LPG)相关烧伤的发生率有所上升,在印度和土耳其等发展中国家,这已成为一个严重的公共卫生问题。本文旨在调查LPG相关烧伤的流行病学特征,为制定预防策略提供帮助和建议。
对2011年1月1日至2015年12月31日期间浙江大学医学院附属第二医院烧伤与伤口护理中心收治的LPG相关烧伤患者进行了一项为期5年的回顾性研究。收集的每位患者信息包括年龄、性别、教育程度、职业、医疗保险、平均住院费用、住院时间、发病月份分布、烧伤部位、烧伤机制、烧伤程度、烧伤部位、伴随损伤及治疗结果。
在最初4年(2011 - 2014年),LPG相关烧伤的年发生率约占所有烧伤的10%;然而,仅在第5年(2015年),这一比例激增至26.94%。在此期间,共收治了1337例烧伤患者。其中,195例患者因169起LPG相关事故入院;有11起事故涉及多名受害者。LPG相关烧伤最常发生在21 - 60岁的患者中(73.85%)。大多数损伤发生在5月至8月(56.41%),最常见的地点是家中(83.08%,162例患者)。气体泄漏(81.03%)是LPG相关烧伤的主要原因,其次是操作不当(7.69%)和烹饪疏忽(2.05%)。平均烧伤面积为总体表面积(TBSA)的31.32±25.40%。最常见的烧伤部位是上肢(37.47%),其次是头/面和颈部(24.80%)以及下肢(19.95%)。最常见的伴随损伤包括吸入性损伤(23.59%)、休克(8.71%)和外伤(7.18%)。平均住院时间为22.90±19.47天(范围2 - 84天)。只有48例患者(24.62%)有医疗保险,而124例患者(63.59%)没有医疗保险。无医疗保险组的平均住院费用显著高于医疗保险组(p<0.0001)。此外,72.73%的自动出院(LAMA)患者没有保险。在我院康复的患者有165例(84.62%),而22例患者(11.28%)自动出院。总死亡率为4.10%(8例患者)。
我们的研究表明,LPG相关烧伤的指数级增长令人担忧。这需要严格的预防措施。由于气体泄漏是LPG相关烧伤的主要原因,LPG炉灶系统任何有老化迹象的部件都应定期更换。此外,我们还发现大多数自动出院患者没有保险。因此,应在康复过程早期纳入全面医疗保险,以确保安全和充分出院。