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小儿烧伤的长期心理社会后遗症

Long-term psychosocial sequelae of paediatric burns.

作者信息

Zeitlin R E

机构信息

Department of Surgery, Tampere University Hospital, Finland.

出版信息

Burns. 1997 Sep;23(6):467-72. doi: 10.1016/s0305-4179(97)00045-4.

Abstract

Ninety-one patients burn-injured in their childhood were assessed by mailed interview and clinical re-examination in 1994. On average, the patients had sustained injuries to 11.9 per cent (SD = 8.8) of their TBSA (maximum 50 per cent), the injuries were mainly scalds (90.1 per cent). Nineteen patients (20.9 per cent) remembered the event and 23 (25.3 per cent) remembered their hospitalisation. The hospitalisation vignettes were significantly associated with painful memories among children older than 3 yr (Fisher's exact test P = 0.04). Seventeen patients (18.7 per cent) had recollections of pain during hospitalisation. They had been confined for an average of 30.9 days. Twenty-one patients (23.1 per cent) had a fear of hot water and fire, and 39 (42.9 per cent) were cautious. The median age at the time of admission was 1.7 yr. The re-examined patients had good school marks and their rate of educational qualifications did not differ from the Finnish national average. No less than one fifth (20.8 per cent, N = 11) had some difficulties with contact with the opposite gender in their adolescence but only one had difficulties later. Fifty-five patients (mostly female, chi 2 = 13.06, DF = 2, P < 0.01) expressed annoyance at their scars, but no more than one third (N = 17) kept them covered continuously. Only five (5.5 per cent) with visible scars had no memories or special psychosocial sequelae. Almost everyone burn-injured in childhood will have some memories of burn care as an adult. However, the negative psychosocial sequale are modest after the typical paediatric burns, scalds, in early childhood.

摘要

1994年,通过邮寄问卷调查和临床复查对91名童年时期遭受烧伤的患者进行了评估。这些患者平均烧伤面积占总体表面积的11.9%(标准差=8.8)(最大为50%),损伤主要为烫伤(90.1%)。19名患者(20.9%)记得受伤事件,23名患者(25.3%)记得住院情况。住院的相关情景与3岁以上儿童的痛苦记忆显著相关(Fisher精确检验P = 0.04)。17名患者(18.7%)回忆起住院期间的疼痛。他们平均住院30.9天。21名患者(23.1%)害怕热水和火,39名患者(42.9%)比较谨慎。入院时的中位年龄为1.7岁。接受复查的患者学业成绩良好,其学历水平与芬兰全国平均水平没有差异。不少于五分之一(20.8%,N = 11)的患者在青春期与异性接触时有一些困难,但只有一人后来仍有困难。55名患者(大多数为女性,卡方=13.06,自由度=2,P < 0.01)对自己的伤疤表示烦恼,但只有不超过三分之一(N = 17)的患者一直遮盖伤疤。只有5名(5.5%)有明显伤疤的患者没有记忆或特殊的社会心理后遗症。几乎每个童年时期遭受烧伤的人成年后都会对烧伤治疗有一些记忆。然而,儿童期典型的小儿烧伤、烫伤后的负面社会心理后遗症并不严重。

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