福州某医院烧伤住院患儿流行病学调查

Epidemiological investigation of hospitalized children with burn injuries in a hospital of Fuzhou

目的分析福建医科大学附属协和医院烧伤住院患儿的流行病学特征，为完善及时有效的儿童烧伤防治系统提供依据。方法收集2012年7月—2015年6月烧伤科收治的14岁及以下烧伤住院患儿的病历资料，统计性别和年龄、致伤地点和原因、致伤时间、伤情、伤后入院时间和现场处理、住院天数和治疗情况等。另将患儿分为4个年龄段：小于或等于1岁、大于1岁且小于或等于3岁、大于3岁且小于或等于7岁、大于7岁且小于或等于14岁，统计各年龄段患儿性别和致伤原因。将患儿受伤入院月份划分为春季（3—5月）、夏季（6—8月）、秋季（9—11月）及冬季（12月—次年2月），统计各季节中患儿致伤原因。统计男女患儿烧伤严重程度，不同致伤原因患儿住院天数。对数据行χ2检验、Wilcoxon秩和检验。 结果笔者单位近3年共收治14岁及以下烧伤患儿1 407例，占烧伤住院患者总数（2 608例）的53.9%。本组患儿中男女比例约1.6∶1.0；4个年龄段中大于1岁且小于或等于3岁患儿最多，占68.3%（961/1 407）。4个年龄段患儿男女构成比比较，差异明显（χ2＝11.00，P＝0.012）。1 372例患儿烧伤发生在室内，占97.5%；35例患儿烧伤发生在室外，占2.5%。本组患儿致伤原因以热液烫伤（95.0%，1 337/1 407）为主。4个年龄段患儿致伤原因构成比比较，差异明显（χ2＝107.23，P〈0.01），大于7岁且小于或等于14岁患儿致伤原因构成比与另3个年龄段比较差异明显（χ2值为12.88～119.85，P值均小于0.01）。本组患儿烧伤高发于17：00—20：59，占33.5%（472/1 407）；4—10月烧伤患儿较多，其中7月（10.4%，146/1 407）与8月（10.5%，148/1 407）为高峰期。本组患儿烧伤多发生在夏季，占35.3%（496/1 407）。各季节中烧伤患儿致伤原因比较，差异明显（χ2＝14.61，P＝0.024）。本组男女患儿均以轻、中度烧伤为主，严重程度相似（Z＝－0.39，P〉0.05）。躯干为最容易受累及的部位，占61.1%（859/1 407）。以伤后2 h内入院者为主，占79.7%（1 121/1 407）。烧伤后在现场以看护者脱去患儿衣物者或未行任何处理居多。本组患儿主要在入院后2周内出院（80.0%，1 126/1 407），热液烫伤、火焰烧伤、电烧伤、高温固体烫伤、化学烧伤引起的烧伤患儿住院天数比较，差异明显（χ2＝17.33，P＝0.002）。本组患儿主要采取非手术治疗方式，最终大部分患儿好转或痊愈出院。结论笔者单位烧伤住院患儿主要为幼儿期男童室内热液烫伤，多集中于夏季用餐及洗澡时间，因此需大力普及烧伤预防知识。

Objective To analyze the epidemiological characteristics of hospitalized children with burn injuries in Fujian Medical University Union Hospital, so as to provide evidence to complete an ade- quate, timely, and effective prevention and treatment system of children with burn injuries. Methods Medical records of children with burn injuries, aged 14 and under, hospitalized in the Department of Burns from July 2012 to June 2015 were collected. Data of gender and age, location and cause of injury, time of injury, state of injury, admission time after injury, first aid, length of hospital stay, and treatment and so on were recorded. They were divided into 4 age brackets ： less than or equal to 1 year old, more than 1 year old and less than or equal to 3 years old, more than 3 years old and less than or equal to 7 years old, more than 7 years old and less than or equal to 14 years old, then gender and cause of injury of children in the 4 age brackets were analyzed. Admission months of the children were divided into spring （March to May） , sum- mer （June to August） , autumn （September to November） and winter （December to February of the follow- ing year） , and then the cause of injury of children in each season was analyzed. Severities of male and fe- male children, length of hospital stay of children with different causes of injury were analyzed. Data were processed with chi-square test, Wilcoxon rank-sum test. Results Out of 2 608 inpatients with burn inju- ries, 1 407 children with burn injuries, aged 14 and under, accounting for 53.9% , were admitted in the re- cent 3 years. The ratio of male to female was 1.6 ： 1.0. Children more than 1 year old and less than or equal to 3 years old ranked the largest number （68.3 % , 961/1 407 ） in the 4 age brackets. There was statistically significant difference in constituent ratios of gender of children among the 4 age brackets （ X z = 11.00, P = 0. 012）. One thousand three hundred and seventy-two children were burned indoors （97.5%）, while 35 children were burned outdoors （2. 5% ）. Scalding with hot fluids was the most common cause of burn （95.0% , 1 337/1 407）. There was statistically significant difference in constituent ratios of injury cause of children among the 4 age brackets （ X 2 = 107.23, P 〈 0.01 ）. There was statistically significant difference in constituent ratios of injury cause of children more than 7 years old and less than or equal to 14 years old compared with those of the other 3 age brackets （withX 2 values from 12. 88 to 119.85, P values below 0.01 ）. Most burn accidents occurred between 17：00 -20：59 （33.5% , 472/1 407）. Burns were more like- ly to happen in April to October. July （10.4% , 146/1 407） and August （10.5% , 148/1 407） were the crest-time. Most of the children were burned in summer （35.3% , 496/1 407）. There was statistically sig- nificant difference in the injury cause of children among each season （X z = 14.61, P =0. 024）. The burn degrees of male and female children were mainly mild or moderate, and there was no statistically significant difference in the severity （ Z = - 0. 39, P 〉 0. 05）. The trunk was the most involved anatomic site （61.1%, 859/1 407）. Most of children were admitted to hospital within 2 hours post burn （79.7%, 1 121/1 407）. Majority of children were taken off clothes as first aid on spot or did not receive any treat- ment. Most of the children were discharged within 2 weeks after admission （80.0% , 1 126/1 407）. There was statistically significant difference in length of hospital stay of children with causes of hot liquid scald, flame burn, electric burn, high temperature solid burn, chemical burn （ X2 = 17.33, P =0. 002）. Most of the children were treated with non-surgical methods, and the majority of the children got better condition or totally recovered and then discharged. Conclusions The majority of hospitalized children with burn inju- ries in our unit are young boys in preschool period, who were burnt by hot fluid at the time of dinner and bathing at home during summer. So we should make more effort on popularization of prevention about burn.