影响烧伤休克发生的相关因素分析

Analysis of correlation factors affecting the incidence of burn shock

目的分析影响烧伤休克发生的相关因素,为烧伤休克的临床治疗提供参考。方法对笔者单位1973-2005年收治的15 624例烧伤患者的临床资料进行回顾性统计,大致以每10年为1个时间段,计算各时间段的休克发生率;分析休克发生率与患者年龄、烧伤面积、伤后入院时间以及并发症发生率之间的关系。结果1973-1980、1981-1990、1991-2000和2001-2005年的休克发生率分别为14．69％、13．50％、9．38％和7．88％,后3个时间段与各自的前一时间段比较,差异均有统计学意义(P<0．01)。7岁以下烧伤患儿及60岁以上老年烧伤患者休克发生率高于其他年龄段患者;烧伤面积越大,休克发生率越高;>伤后4 h至≤12 h入院的患者休克发生率高于其他时间段入院者(P<0．01)。烧伤休克患者脓毒症、消化道出血、急性肾功能衰竭、肺功能衰竭、心功能衰竭等并发症发生率明显高于未发生休克的患者(P<0．01)。结论应加强对小儿及老年烧伤患者休克的防治。伤后积极进行液体复苏,对防治休克、预防内脏并发症、提高治愈率有重要意义。

Objective To analyze the correlation factors affecting the incidence of burn shock,so as to provide guidance for the clinical treatment of shock after burns. Methods Retrospective analysis of clinical data of 15 624 patients hospitalized in our department from 1973 to 2005 was undertaken . The incidence of shock during every 10 years, as well as the relationship between shock incidence and age, burn area, interval between injury and hospitalization, and complications were analyzed statistically. Results The incidence of shock during 1973-1980, 1981-1990, 1991--2000 and 2001-2005 periods was 14. 69% , 13.50% , 9.38% and 7.88% , respectively, and there was significant difference of shock incidence between each 10 years and its succeeding period（ P 〈0.01 ）. The occurrence of shock was closely related to age , length of time between injury and hospitalization, and burn area. The shock incidence of children under 7 years old or elderly more than 60 years old was obviously higher than other age groups, and there was positive relationship between burn area and shock incidence. Moreover, the shock incidence of the patients hospitalized later than 4 to 12 hours after burn shock was also markedly higher than those hsopitalized earlier （ P 〈 0.01）. In addition, the incidence of sepsis, alimentary tract hemorrhage, acute renal failure, pulmonary failure, and cardiac failure in patients with shock was obviously higher than those without shock （ P 〈 0. 01 ）, Conclusion For the chidren and aged people, special attention should be paid in the prevention and resuscitation of burn shock. Early fluid resucitation is vital for the prevention of organ complication, and it is beneficial to promote wound healing.