特重度烧伤的特点及预后影响因素探讨

Investigation into clinical characteristics of severe burn and factors influencing its prognosis

目的探讨特重度烧伤的特点及预后影响因素。方法选取2008年4月—2013年4月在我院住院治疗的特重度烧伤患者80例,根据患者的预后分为存活组(62例)与死亡组(18例),对两组患者的一般情况及入院时的烧伤面积、Ⅲ度烧伤面积、复合伤、吸入性损伤、并发呼吸功能不全、肾功能不全、消化道出血以及全身感染等因素进行比较。结果两组患者性别比较无统计学差异,死亡组年龄较存活组患者大(P<0.05),烧伤面积以及Ⅲ度烧伤面积也明显大于存活组(P<0.05),两组患者在复合伤以及合并吸入性损伤方面比较并无统计学差异(P>0.05),但死亡组患者并发呼吸功能不全、肾功能不全、消化道出血以及感染的概率明显高于存活组,两组比较有统计学差异(P<0.05)。结论烧伤致患者死亡的主要原因是内脏并发症引起的多器官功能障碍综合征,影响患者预后的因素有年龄、烧伤面积、烧伤深度、呼吸功能不全、肾功能不全、消化道出血以及全身感染等。

Objective To investigate the clinical characteristics of severe burn and factors influencing its prognosis. Methods A total of 80 severely burned patients admitted from April 2008 to April 2013 were divided into survival group （ n = 62 ） and death group （n = 18 ） according to their sequelae. Comparison was carried out in aspects of gender, age, burned area, compound injury, inhalation injury, combined respiratory insufficiency, renal insufficiency and gastrointestinal hemorrhage and systemic infection between the two groups. Results There were no statistical differences in gender, compound injury and inhalation injury （P 〉 0.05 ）. Age, burned area （including III degree burn area） and rates of combined respiratory insufficiency, renal insufficiency and gastrointestinal hemorrhage and systemic infection were respectively older, larger and higher in the death group than in the survival group （ P 〈 0.05 ）. Conclusion Multiple organ dysfunction syndrome （MODS） is the main lethal disorder in severely burned patients. The factors influencing their prognosis include age, burned area and depth, respiratory insufficiency, renal insufficiency, gastrointestinal hemorrhage and systemic infection.