32例小儿腐蚀性食道烧伤原因分析与防范对策

Causes and prevention of corrosive esophageal burn of 32 children

目的分析小儿腐蚀性食管烧伤发病原因、院前救治措施及家属对腐蚀性物质安全防护认知情况,以便规范化地给予预防。方法回顾西安交通大学第二附属医院小儿外科2001年1月-2019年1月收治的32例小儿腐蚀性食管烧伤病例,根据农村和城镇、家属文化水平及腐蚀性物质安全防护认知情况等分组,SPSS 24.0软件进行统计分析。结果32例小儿腐蚀性食管烧伤就诊的患儿中,农村24例(75.00%),城镇8例(25.00%);11例患儿家属表示曾了解腐蚀性物质安全防护相关知识,农村4例,城镇7例;9例患儿家属表示曾采取相关院前急救措施,农村3例,城镇6例;农村患儿家属对腐蚀性物质安全防护认知及采取院前急救措施的比例均显著低于城镇,分别为16.7%、12.5%和87.5%、75.0%(P<0.05);接受家属院前急救的患儿预后明显优于未接受家属院前急救的患儿,球囊扩张次数明显较少且住院天数短[分别为(6.00±2.89)次和(9.00±2.94)次,t=2.61,P<0.05;(56.00±3.65)d和(65.00±9.53)d,t=2.73,P<0.05]。结论小儿腐蚀性食管烧伤的发生不仅跟儿童本身的特点有关,还与地域、家庭、社会等因素密切相关,院前采取一定的急救措施对预后有明显的积极作用,提示有关部门应加强城乡腐蚀性物质安全防护相关宣教工作,并侧重于广大农村地区。

Objective To analyze the causes of corrosive esophageal burn in children,the pre-hospital cares and family members′knowledge about the safety of corrosive substances,so as to afford standardized prevention.Methods A total of 32 cases of pediatric corrosive esophageal burn admitted by the Pediatric Surgery Department of the Second Affiliated Hospital of Xi′an Jiaotong University from January 2001 to January 2019 were reviewed,and were grouped by rural areas and urban areas,the families′educational level and the knowledge about the safety of corrosive substances.The results were analysed using the software SPSS 24.0.Results There were 24 cases(75.0%)in rural areas,8 cases(25.0%)in urban areas of 32 cases.The family members of 11 cases said they had known about the knowledge of corrosive substances,including 4 in rural areas and 7 in urban areas,the family members of 9 cases said that they had taken relevant pre-hospital cares,including 3 in rural areas and 6 in urban areas,both of the percentage of family members in rural areas who had knowledge about corrosive substances and adopted pre-hospital cares were significantly lower than those in urban areas,with 16.7%,12.5%and 87.5%,75.0%,respectively(P<0.05).The prognosis of the children who received pre-hospital cares was significantly better than that of the children who did not receive pre-hospital cares,with fewer balloon dilation times and shorter hospitalization days[(6.00±2.89)times and(9.00±2.94)times respectively,t=2.61,P<0.05;(56.00±3.65)d and 65.00±9.53)d respectively,t=2.73,P<0.05).Conclusions Children corrosive esophageal burns occurs is not only related to the characteristics of the children themselves,but also is closely related to the geography,family,society,etc.The certain pre-hospital cares have obvious positive effect to the prognosis,reminding that relevant departments should strengthen the educational propaganda work on the safety knowledge of corrosive substance,especially focusing on the vast rural areas.