108例严重烧伤患儿的临床特点及治疗分析

Clinical characteristics and treatment of 108 children with severe burns

目的:分析严重烧伤住院患儿的临床特点及治疗过程,总结临床经验。方法:收集笔者单位2015年4月-2016年11月间重度烧伤患儿的临床资料。分析患儿性别、致伤原因、致伤部位、烧伤面积、创面处理,根据手术与否,分为手术组和非手术组。对数据行t检验。结果:本次收录108例严重烧伤住院患儿。(1)108例患儿中,6岁以下的患儿占86.1%;男性患儿67例,占62%,女性患儿41例,占38%。致伤原因以热液烫伤为主,占82.4%;大于6岁且小于或等于12岁的患儿致伤原因中以火焰烧伤为主,占80%。(2)本组患儿烧伤总面积以15%~39%为主,占82.4%;50%TBSA以上患儿只占10.1%。最常见的致伤部位所占比例从高到低依次为躯干(76.9%)、下肢(73.1%)、上肢(65.7%)、头面颈(53.7%)、臀部(33.3%)、手(25%)。(3)手术组与非手术组患儿烧伤总面积比较,无显著性差异(P>0.05);在Ⅲ度烧伤面积,手术组与非手术组比较,差异显著(P<0.01);手术组患儿住院时间明显高于非手术组(P<0.01)。结论:小儿烧伤以6岁以下儿童为主,致伤原因多为烫伤。早期及时有效的防治休克、保护创面、预防感染、尽快手术封闭创面、加强全身营养支持,以提高重度烧伤患儿的治愈率。

Objective To analyze the clinical characteristics and treatment of hospitalized children with severe burns and to summarize the clinical experience. Methods The clinical data of the patients with severe burns hospitalized in The First Affiliated Hospital of Anhui Medical University from April 2015 to November 2016 were collected. Gender, the cause of injury,the site of injury,the area of burn and the treatment of wound were analyzed and patients were assigned into operation group and nonoperation group according to the operation. Data were processed with T test. Results One hundred and eight hospitalized children with severe burns were included in this study. （1）Children under 6 years old ac- counted for 86.1%. There were 67 cases of boy patients （62%） and 41 cases of girl patients （38%）. The main cause of injury was scalded by hot liquid （82.4%）. For children over 6 years of age and less than or equal to 12 years old,the leading cause of injury was fire burns （80%）. （2）The total area of burn was mainly 15% to 39% among children,ac- counting for 82.4%. 50% TBSA children accounted for only 10. 1%. The most common injuries were the body （76. 9%） ,lower limbs （73.1%） ,upper limbs （65.7%） ,head and neck （53.7%） ,hip （33.3%） ,and hand （25%）. （3）There was no significant difference between operation group and nonoperation group in total burn area（P〉0.05）. There was significant difference between two groups in the third degree burn area（P〈0.01）. Hospital stay in operation group was significantly longer than that in nonoperative group（P〈0.01）. Conclusions The majority of children with burns are un- der 6 years old,and most of the injuries are caused by burns. Early and effective prevention and treatment of shock, wound surface protect, infection prevention, surgical operation, wound sealing, and body nutrition support are helpful in improving the cure rate of children with Severe burns.