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电气损伤及结局:回顾性研究

Electrical injuries and outcomes: A retrospective review.

机构信息

Department of Surgery, Acute Care Surgery Division, USA.

Department of Surgery, Acute Care Surgery Division, USA.

出版信息

Burns. 2023 Nov;49(7):1739-1744. doi: 10.1016/j.burns.2023.03.015. Epub 2023 Mar 23.

Abstract

Electrical burns (EI) differ from other burn injuries in the immediate treatment given and delayed sequelae they manifest. This paper reviews our burn center's experience with electrical injuries. All patients with electrical injuries admitted from January 2002 to August 2019 were included. Demographics; admission, injury, and treatment data; complications, including infection, graft loss, and neurologic injury; pertinent imaging, neurology consultation, neuropsychiatric testing; and mortality were collected. Subjects were divided into those who were exposed to high (>1000 volts), low (<1000 volts), and unknown voltage. The groups were compared. P < 0.05 was considered significant. One hundred sixty-two patients with electrical injuries were included. Fifty-five suffered low voltage, 55 high voltage, and 52 unknown voltage injuries. High voltage injuries were more likely to be male (98.2% vs. 83.6% low voltage vs. 94.2% unknown voltage, p = 0.015), to experience loss of consciousness (69.1% vs. 23.6% vs. 33.3%, p < 0.001), cardiac arrest (20% vs. 3.6% vs. 13.4%, p = 0.032), and undergo amputation (23.6% vs. 5.5% vs. 8.2%, p = 0.024). No significant differences were observed in long-term neurological deficits. Twenty-seven patients (16.7%) were found to have neurological deficits on or after admission; 48.2% recovered, 33.3% persisted, 7.4% died, and 11.1% did not follow-up with our burn center. Electrical injuries are associated with protean sequelae. Immediate complications include cardiac, renal, and deep burns. Neurologic complications, while uncommon, can occur immediately or are delayed.

摘要

电烧伤(EI)在给予的即时治疗和表现出的延迟后遗症方面与其他烧伤损伤不同。本文回顾了我们烧伤中心的电烧伤经验。所有 2002 年 1 月至 2019 年 8 月期间收治的电烧伤患者均纳入研究。收集了人口统计学资料;入院时、损伤时和治疗时的数据;并发症,包括感染、移植物丢失和神经损伤;相关影像学、神经科会诊、神经心理学测试;以及死亡率。受试者分为暴露于高电压(>1000 伏特)、低电压(<1000 伏特)和未知电压的三组。比较了各组。P<0.05 被认为具有统计学意义。共纳入 162 例电烧伤患者。55 例为低电压损伤,55 例为高电压损伤,52 例为未知电压损伤。高电压损伤更可能为男性(98.2%比低电压损伤的 83.6%和未知电压损伤的 94.2%,p=0.015),更易发生意识丧失(69.1%比低电压损伤的 23.6%和未知电压损伤的 33.3%,p<0.001)、心脏骤停(20%比低电压损伤的 3.6%和未知电压损伤的 13.4%,p=0.032)和截肢(23.6%比低电压损伤的 5.5%和未知电压损伤的 8.2%,p=0.024)。在长期神经功能缺损方面未见显著差异。27 例(16.7%)患者在入院时或之后发现有神经功能缺损;48.2%恢复,33.3%持续存在,7.4%死亡,11.1%未在我们的烧伤中心进行随访。电烧伤可引起多种后遗症。即刻并发症包括心脏、肾脏和深部烧伤。神经并发症虽然不常见,但可即刻发生或延迟发生。

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