近四年广西某医院儿童烧伤流行病学分析

发布时间：2018-10-15 08:45

【摘要】：目的:通过采集并分析2013年3月至2017年2月广西医科大学第一附属医院烧伤整形外科儿童烧伤住院患者流行病学数据,建立儿童烧伤流行病学数据库,为制定干预措施,降低儿童烧伤率提供临床依据。方法:收集广西医科大学第一附属医院烧伤整形外科2013年3月至2017年2月收治住院的1158例0至14岁儿童烧伤的病例资料,并对年龄、性别、致伤原因、受伤季节、城乡分布及烧伤严重程度等进行回顾性统计分析。结果:4年中,广西医科大学第一附属医院烧伤整形外科共收治1158例烧伤儿童。其中,男性烧伤患儿占61.0%(706例),女性患儿占39.0%(452例),男:女=1.56:1。3-7岁年龄组儿童比例最高占54.5%(631例),其次,0-3岁年龄组儿童占34.2%(396例),7-14岁年龄组儿童比例最低11.3%(131例)。乡村患儿占71.5%(828例),城市患儿占28.5%(330例)。乡村患儿:城市患儿为2.51:1,乡村患儿比例明显高于城市。5%TBSA以下者占14.9%(173例),5-15%TBS之间(包括5%TBSA)者占47.7%(552例),15-25%TBSA之间(包括15%TBSA)者占21.2%(246例),25%TBSA及以上者占16.2%(187例)。轻度烧伤患儿占8.8%(102例),中度烧伤患儿占46.6%(540例),重度烧伤患儿占27.4%(317例),特重度烧伤患儿占17.2%(199例)。致病原因中,热水、热油、热汤等烫伤者占86.7%(1004例)。火焰、烟花、电火花等火焰烧伤者占9.6%(111例),电损伤占2.3%(27例),强酸、强碱等化学烧伤占1.4%(16例)。致病季节中,春季占25.2%(292例),夏季占22.9%(265例),秋季占23.7%(275例),冬季占28.2%(326例)。儿童烧伤后至入院期间,看护者未及时处理有448例,创面冷水冲洗、冰敷、烧伤膏、直接外院处理有381例,其他如涂抹牙膏、蜂蜜、芦荟、尿液、中药、白酒等有329例。入院后,创面需要手术治疗的有312例,通过换药等非手术治疗者有846例。其中输血治疗有266例,未输血者有892例。住院时间中,住院时间≤7天出院有577例,7住院天数≤14天出院者有314例,14住院天数≤21天出院者有130例,3周以上患儿有137例,死亡率为0.3%(3例)。根据患儿医保覆盖情况,其中自费484例,医保支付674例,人均治疗费用为1.4243万元。结论:2013年3月至2017年2月,广西医科大学第一附属医院烧伤整形外科收治的住院患儿中,男孩比例明显高于女孩、3-7岁年龄组构成比最高、热液烫伤仍为主要致伤因素、农村儿童发病率高于城市儿童、烧伤在2月份所占比例最高,其次是10月份,冬季所占比例最高,其次是春季。伤后现场能基本正确、简单地处理创面者占32.9%。
[Abstract]:Objective: to collect and analyze the epidemiological data of pediatric burn patients in the first affiliated Hospital of Guangxi Medical University from March 2013 to February 2017. To reduce the rate of burn in children provides clinical basis. Methods: the data of 1158 cases of burn and plastic surgery hospitalized in the first affiliated Hospital of Guangxi Medical University from March 2013 to February 2017 were collected, and the age, sex, cause and season of injury were analyzed. The distribution of urban and rural areas and the severity of burns were analyzed retrospectively. Results: in 4 years, 1158 cases of burn children were treated in the first affiliated Hospital of Guangxi Medical University. Among them, 61.0% (706 cases) were male burns, 39.0% (452 cases) were female, 54.5% (631 cases) were male: female = 1.56: 1.3-7 years old, 36.2% (396 cases) were 0-3 years old, and the lowest was 11.3% (131 cases) in 7-14 age group. 71.5% (828 cases) were in rural areas and 28.5% (330 cases) in urban areas. The proportion of rural children was 2.51: 1, and the proportion of rural children was significantly higher than that of urban children. The proportion of children below 5%TBSA was 14.9% (173 cases), between 5-15%TBS (including 5%TBSA) was 47.7% (552 cases), between 15-25%TBSA (including 15%TBSA) was 21.2% (246 cases), 25%TBSA and above was 16.2% (187 cases). Mild burns accounted for 8.8% (102 cases), moderate burns accounted for 46.6% (540 cases), severe burns accounted for 27.4% (317 cases), severe burns accounted for 17.2% (199 cases). Hot water, hot oil, hot soup and other scalds accounted for 86.7% (1004 cases). Fire, fireworks and electric sparks were found in 9. 6% (111 cases), electrical injuries in 2. 3% (27 cases), and chemical burns such as strong acid and alkali in 1. 4% (16 cases). Among the pathogenic seasons, the incidence in spring was 25.2% (292 cases), in summer 22.9% (265 cases), in autumn 23.7% (275 cases), and in winter 28.2% (326 cases). During the period from burn to admission, there were 448 cases not treated in time. There were 381 cases of cold water flushing, ice compress, burn ointment, and other cases such as toothpaste, honey, aloe, urine, traditional Chinese medicine, white wine and other 329 cases. After admission, 312 cases needed surgical treatment and 846 cases were treated by non-surgical treatment such as dressing change. There were 266 cases treated with blood transfusion and 892 cases without blood transfusion. Among them, 577 cases were discharged with less than 7 days, 314 cases with 7 days of stay 鈮，

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