100例严重烧伤死亡病例分析

Clinical Analysis of Death Causes in 100 Burn Patients

目的 通过对两阶段烧伤死亡病人基本情况进行对比分析 ,以期探讨进一步提高烧伤救治率的有效措施。方法 总结近 2 0年死亡烧伤病人 10 0例 ,按前后各 10年各 5 0例病人分组 (A和B两组 ) ,对其病死率 ,烧伤面积 ,深度 ,致伤原因 ,院前治疗情况 ,入院时间 ,存活时间 ,吸入伤 ,气管切开 ,呼吸机与纤支镜的应用 ,手术例次 ,血液透析及死亡原因等进行对比分析。结果 两组烧伤严重程度无差别 ,致伤原因 (多为火焰 ,爆炸和热液 )和死亡原因 (严重全身感染 ,多脏器衰竭和吸入性损伤 )也类似 ,而近 10年烧伤病死率明显降低 ,而入院时间明显滞后 ,但病人入院后存活时间明显延长 ,进一步分析发现近 10年气管切开和呼吸机应用更加积极和应用广泛 ,纤支镜辅助检查和治疗增多 ,手术积极并例次增多 ,血液透析病例增多。结论 近 10年积极的气管切开 。

Objective To analyze the death causes of the burn patients so as to explore the effective procedures which can raise burn management level. Methods One hundred patients died of burn injury during the past 20 years were enrolled in the study. The died patients were grouped as A (1984～1993) and B (1994～2003) groups, each group containing 50 cases. The mortality, burn area and depth, etiology, pre-hospital treatment, admission time, survival time, tracheostomy, the application of respirator and fibrobronchoscope, operation times, continuous renal replace treatment (CRRT), the incidence of inhalation injury and the pathogenesis of burn death were analyzed and compared between A and B groups. Results There were no differences in burn severity (area and degree), etiology and causes of burn death between the two groups. But the mortality in B group (1%) was evidently lower than that in A group (2%, P<0 05). The patients in B group survived much longer time than those in A group (P<0 01). In addition, tracheostomy, respirator, fibrobronchoscope, CRRT and operations were employed more actively in B group. Conclusions Active comprehensive treatment of severely burned patients using tracheostomy, respirator, operations and CRRT, etc. might be beneficial to the prolongation of survival time in the severely burn patients.