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基于 2012 年固城化学物质泄漏灾难后主要烧伤标准的氟化氢暴露患者的比较分析。

Comparative Analysis of Hydrogen Fluoride-Exposed Patients Based on Major Burn Criteria After the 2012 Gumi City Chemical Leak Disaster.

机构信息

Environmental Health Center, Soonchunhyang University Gumi Hospital, Gumi, Republic of Korea and Department of Emergency Medicine, Soonchunhyang University Hospital, Bucheon, Republic of Korea.

Environmental Health Center, Soonchunhyang University Gumi Hospital, Gumi, Republic of Korea and Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.

出版信息

J Burn Care Res. 2022 Jul 1;43(4):834-840. doi: 10.1093/jbcr/irab206.

Abstract

This study conducted to analyze and compare the epidemiological and clinical characteristics of hydrogen fluoride-exposed patients based on major burn criteria for the appropriate emergency department (ED) response to a mass casualty chemical spill. This retrospective cross-sectional study included the records of patients (n = 199) who visited the ED of Gumi City University Hospital from September 27, 2012, to October 20, 2012. Subjects were included in the major burn group (MBG) if they presented with wounds that required referral to a burn center according to the American Burn Association guidelines or in the nonmajor burn group (NMBG) if not. Males were predominant in both the MBG (n = 55, 48 males) and NMBG (n = 144, 84 males; P < .05). The most prevalent timeline for visiting the ED was the phase which included 9-32 hours post-leak of hydrogen fluoride, including 45 patients (81.8%) in the MBG and 122 patients (84.7%) in the NMBG (P < .001). The respiratory tract was the site of greatest damage in patients in both the MBG and NMBG (n = 47, 85.5% vs n = 142, 98.6%, P < .001). Regarding dispositions, all patients in the NMBG were discharged (n = 144, 100%); however, eight patients (14.5%) in the MBG underwent other dispositions (discharge against medical advice, five patients; admission, one patient; death, two patients, P < .05). Patient outcomes after major chemical contamination events should be characterized in future studies to maximize the quality of patient care.

摘要

本研究旨在根据主要烧伤标准分析和比较氢氟酸暴露患者的流行病学和临床特征,以便为大规模化学事故伤患者提供适当的急诊(ED)反应。这是一项回顾性的横断面研究,纳入了 2012 年 9 月 27 日至 10 月 20 日期间到古米市大学医院 ED 就诊的 199 名患者的记录。如果患者的伤口根据美国烧伤协会指南需要转诊到烧伤中心,则将其纳入主要烧伤组(MBG);否则,将其纳入非主要烧伤组(NMBG)。在 MBG(n = 55,48 名男性)和 NMBG(n = 144,84 名男性)中,男性均占优势(P <.05)。就诊 ED 的最常见时间是氢氟酸泄漏后 9-32 小时,包括 MBG 中的 45 名患者(81.8%)和 NMBG 中的 122 名患者(84.7%)(P <.001)。呼吸道是 MBG 和 NMBG 中患者损伤最严重的部位(n = 47,85.5% vs n = 142,98.6%,P <.001)。关于处理结果,NMBG 中的所有患者均出院(n = 144,100%);然而,MBG 中有 8 名患者(14.5%)接受了其他处理(出院后无医嘱、5 例;入院、1 例;死亡、2 例,P <.05)。在未来的研究中,应描述重大化学污染事件后的患者结局,以最大限度地提高患者护理质量。

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