25年1043例危重烧伤住院患者调查分析

Epidmiological investigation of 1043 critical and severe burn patients in 25 years

目的调查危重烧伤患者的致病相关因素及发病规律,为危重烧伤的预防提供理论依据。方法回顾性分析1982-2006年25年间收治的全部1 043例危重烧伤住院患者的临床资料,统计分析性别比例、年龄分布、致伤因素、受伤场所、季节分布、来诊时间、合并症情况、病死率等。结果25年来烧伤患者呈逐年上升趋势,且危重烧伤成倍增长,危重烧伤患者占全部烧伤患者的比例为6.6%(1 043/15 915)。1 043例危重烧伤患者中,男女比例为3.3∶1,但近5年来该比例明显缩小;危重烧伤患者中18～60岁成年人最多,占60.6%,其次为婴幼儿和学龄前儿童;婴幼儿的受伤比例呈显著上升趋势,近5年已占危重烧伤患者的41.2%。危重烧伤的季节分布从高到低依次为夏季(40.3%)、春季(23.5%)、秋季(22.4%)、冬季(13.8%);生活和工作中受伤比例分别为54.8%、45.2%,近5年生活中受伤比例迅速增加,占63.3%;热力为主要致伤因素(占85.5%),其中又以火焰烧伤居多,但热液烧伤呈逐年增多的趋势;伤后6h内就诊的患者只占51.2%;接诊时21.0%合并吸入性损伤,17.7%合并休克;危重烧伤病死率逐年下降,已从1982-1986年的16.3%下降至2002-2006年的4.2%。结论危重烧伤预防工作的开展迫在眉睫;预防的重点人群是青壮年和7岁以下的儿童;除工矿企业外,应加强社区居民日常生活安全和发生火灾时的自救、自我保护的宣教;应尽快开展简便易行的危重烧伤患者入院前休克预防方案的应用研究。

Objective To investigate the etiological and epidemiological factors of critical and severe bum injuries, in tending to provide a theoretical basis for the prevention of critical and severe burn injury. Methods The clinical data of a total of 1043 patients with critical and severe bum injury hospitalized from 1982 to 2006 were retrospectively analyzed, and the sex ratio, age distribution, etiological factors, injury sites, seazonal distribution, duration before hospitalization, complications and fatality of these patients were statistically ana- lyzed. Results From 1982 to 2006, the number of bum patients admitted to our hospital presented an increasing trend, and the number of critical and severe burn patients increased obviously. The sex ratio （male/female） was 3.3：1, and it obviously declined during the last 5 years. The proportion of infant and childhood patients presented a significantly increasing trend, occupying 41.2% of critical and severe burn patients in the last 5 years. Summer was the predominating season for occurrence of burn injury （40.3%）, followed by spring （23.5%）, autumn （22.4%） and winter （13.8%）. 54.8% of burn injury occurred in daily life, the remaining 45.2% of patients got burn injury in work, but the former reached 63.3% in the last 5 years. Heat was the main etiological factor, occupying 85.5%, of which flame was the most important cause, and hot fluid scald was increasing in recent years. Only 51.2% of the patients went to visit doctor within 6h after injury. 21.0% of the patients were complicated with inhalation injury, and 17.7% was in shock when they came to the hospital. The fatality rate of critical and severe burns was reduced from 16.3% （1982-1986） to 4.2% （2002-2006）. Conclusions It is urgent to prevent critical and severe bums, especially in the youth and childhood. Information regarding prevention, self-aid and self-protection in fire accident should be actively spread among both the workers in industrial and mining enterprises and community inhabitants. The methods easy to use for shock prevention before hospitalization should be explored as early as possible.