학술논문
多中心严重烧伤住院患儿流行病学调查分析 / Multicenter epidemiological investigation of hospitalized children with severe burn
Document Type
Academic Journal
Source
中华烧伤杂志 / Chinese Journal of Burns. 32(10):599-605
Subject
Language
Chinese
ISSN
1009-2587
Abstract
目的 分析3年间我国多个地区严重烧伤住院患儿的流行病学特征,为预防儿童烧伤提供依据.方法 依托“临床多中心严重烧伤流行病学病例数据与生物样本录入系统”,收录6家笔者单位2012年2月—2015年2月收治的、18岁及以下严重烧伤住院患儿的病历资料.将患儿按年龄段分为小于或等于l岁、大于1岁且小于或等于3岁、大于3岁且小于或等于6岁、大于6岁且小于或等于12岁、大于12岁且小于或等于18岁5类,按居住地分为农村和城市2类,统计分析各年龄段患儿的性别及居住地,各年龄段及各居住地患儿的致伤原因、致伤场所、烧伤总面积、致伤部位、吸入性损伤和复合伤、住院费用来源,本组患儿的治疗结局、住院天数.另统计不同致伤场所中患儿的致伤原因分布.另将患儿分为小于或等于6岁和大于6岁且小于或等于18岁,比较2个年龄段患儿的手足部烧伤发生率.对数据行x2检验,对年龄和烧伤总面积的相关性行Spearman相关分析.结果 本次收录严重烧伤住院患儿440例,占同期录入严重烧伤住院患者总数(1 106例)的39.8％.(1)本组患儿中男童较多(270例,占61.4％),5个年龄段中以大于1岁且小于或等于3岁的患儿最多(222例,占50.5％),居住地为农村与城市的患儿数比例为2.9:1.0.各年龄段患儿男女构成比和居住地分布比较,差异均无统计学意义(x2值分别为7.649和9.399,P值均大于0.05).(2)本组患儿致伤原因以烫伤为主.各年龄段患儿致伤原因比较,差异明显(x2=136.307,P＜0.001).不同居住地患儿致伤原因比较,差异无统计学意义(x 2=5.164,P＞0.05).(3)本组患儿最主要致伤场所为私人住宅.各年龄段患儿致伤场所比较,差异明显(x 2=124.930,P＜0.001).不同居住地患儿致伤场所比较,差异无统计学意义(x 2 =3.364,P＞0.05).本组患儿在不同致伤场所致伤原因差异明显(x 2=118.284,P＜0.001).(4)本组患儿烧伤总面积以10％ ～ 39％ TBSA为主.各年龄段患儿烧伤总面积比较,差异明显(x 2=103.568,P＜0.001).本组患儿年龄与烧伤总面积之间呈正相关(r=0.177,P＜0.001).不同居住地患儿烧伤总面积比较,差异不明显(x2=16.213,P＞0.05).(5)本组患儿最常见的致伤部位比例从高到低依次为躯干、下肢、上肢.各年龄段患儿致伤部位比较,差异明显(x 2 =45.674,P=0.019).小于或等于6岁与大于6岁且小于或等于18岁患儿手、足部烧伤发生率均差异明显(x2值分别为29.188和14.612,P值均小于0.01).不同居住地患儿致伤部位比较,差异无统计学意义(x2 =8.515,P＞0.05).(6)本组患儿中27例合并吸入性损伤,以大于12岁且小于或等于18岁(8例)患儿为主,以农村患儿居多(18例).吸入性损伤致伤原因中以火焰烧伤居多(23例).本组有9例患儿伴复合伤,以大于12岁且小于或等于18岁年龄段最多(5例),以城市患儿居多(5例).(7)437例患儿中住院费用来源以自费为主.各年龄段患儿的住院费用来源差异明显(x2=17.917,P=0.001).不同居住地患儿住院费用来源比较,差异无统计学意义(x2=0.749,P＞0.05).(8)437例患儿中34例因治疗费用不足放弃治疗出院.78例患儿病情好转,347例患儿治愈;分别各有6例患儿病情恶化或死亡.本组患儿平均住院28.6 d,其中病情恶化和死亡患儿平均住院8.8d.结论 儿童是我国目前严重烧伤的主要群体,主要见于6岁及以下儿童,多为男童,致伤原因多为烫伤,多在私人住宅致伤,最常见的致伤部位依次为躯干、下肢、上肢,住院费用以自费为主.不同年龄段患儿的致伤原因、致伤场所、烧伤总面积、致伤部位和住院费用来源情况存在明显差异.
Objective To analyze the epidemiological characteristics of hospitalized children with severe burn from several regions in China during 3 years,so as to provide evidence for prevention of burns in children.Methods Relying on the entry system of epidemiology data and biological sample of severe burn from multicenter in clinic,medical records of children with severe burn,aged 18 and under,hospitalized in 6 burn wards from February 2012 to February 2015 were collected.The children were divided into 5 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 6 years old,more than 6 years old and less than or equal to 12 years old,more than 12 years old and less than or equal to 18 years old.Meanwhile the children were divided into rural and urban children according to their residences.Data of gender and residence of children in the 5 age brackets,cause of injury,location of injury,total burn area,wound site,inhalation injury and combined injury,and source of hospitalization expenses of children in the 5 age brackets and two types of residence,and outcome and length of hospital stay of the children were analyzed.The cause of injury of children in different location of injury was analyzed.In addition,they were divided into 2 age brackets:less than or equal to 6 years old and more than 6 years old and less than or equal to 18 years old,and then incidences of hand and foot burn injury were compared.Data were processed with chi-square test,and the correlation between age and total burn area was processed with Spearman correlation analysis.Results Four hundred and forty out of 1 106 inpatients with severe burn were children,accounting for 39.8％ who were included in the system.(1) The majority of children were male (270,61.4％).The number of children more than 1 year old and less than or equal to 3 years old ranked the first (222,50.5％) in the 5 age brackets.The ratio of children from rural areas to that from urban areas was 2.9:1.0.There were no statistically significant differences in both gender and residence of children among the 5 age brackets (withx2 values respectively 7.649 and 9.399,P values above 0.05).(2) Scald was the most common cause of burn.There was statistically significant difference in injury cause of children among the 5 age brackets (x 2 =136.307,P ＜ 0.001).There was no statistically significant difference in injury cause of children among the two types of residence (x2 =5.164,P ＞0.05).(3) Private house was the most common location of injury.There was statistically significant difference in location of injury of children among the 5 age brackets (x 2 =124.930,P ＜0.001).There was no statistically significant difference in location of injury of children among the two types of residence (x 2 =3.364,P ＞ 0.05).There was statistically significant difference in injury cause of children in different location of injury (x 2 =118.284,P ＜ 0.001).(4) Most of children were with total burn areas from 10％ to 39％ total body surface area.There was statistically significant difference in total burn area of children among the 5 age brackets (x 2 =103.568,P ＜ 0.001).There was positive correlation between age and total burn area (r =0.177,P ＜ 0.001).There was no statistically significant difference in total burn area of children among the two types of residence (x 2 =16.213,P ＞ 0.05).(5) Trunk,lower extremity,and upper extremity were the most common wound sites,respectively.There was statistically significant difference in wound site of children among the 5 age brackets (x 2 =45.674,P =0.019).There was statistically significant difference in incidence of hand and foot burn between children less than or equal to 6 years old and children more than 6 years old and less than or equal to 18 years old (withx 2 values respectively 29.188 and 14.612,P values below 0.01).There was no statistically significant difference in wound site of children among the two types of residence (x 2 =8.515,P ＞ 0.05).(6) Twenty-seven children suffered inhalation injury.The main age bracket was more than 12 years old and less than or equal to 18 years old (8 children).The main residence was rural area (18 children).The main cause of inhalation injury was flame burn (23 children).Nine children suffered combined injury,among which the children more than 12 years old and less than or equal to 18 years old accounted for the highest ratio (5 children),and the urban children accounted for higher ratio (5 children).(7) Among the 437 children,most of their hospitalization expenses were at their own expense.There was statistically significant difference in the source of hospitalization expenses of children among the 5 age brackets (x2 =17.917,P =0.001).There was no statistically significant difference in the source of hospitalization expenses of children among the two types of residence (x 2 =0.749,P ＞0.05).(8) Among the 437 children,34 children abandoned treatment and were discharged from hospital,attributed to lack of funding.Seventy-eight children were discharged with a better health condition and 347 were cured.The condition of 6 children worsened and 6 children died.Mean length of hospital stay was 28.6 days for all the children,and 8.8 days for the deteriorated and dead children.Conclusions Children were the major group of patients with severe burn in China.Male children less than or equal to 6 years old were common with scald as the major cause of injury,private house as the major location of injury,and trunk,lower and upper extremity as the most common wound sites,their own expenses as the major source of hospitalization expenses.There were statistically significant differences in cause of injury,location of injury,total burn area,wound site,and hospitalization expenses source of children among the 5 age brackets.
Objective To analyze the epidemiological characteristics of hospitalized children with severe burn from several regions in China during 3 years,so as to provide evidence for prevention of burns in children.Methods Relying on the entry system of epidemiology data and biological sample of severe burn from multicenter in clinic,medical records of children with severe burn,aged 18 and under,hospitalized in 6 burn wards from February 2012 to February 2015 were collected.The children were divided into 5 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 6 years old,more than 6 years old and less than or equal to 12 years old,more than 12 years old and less than or equal to 18 years old.Meanwhile the children were divided into rural and urban children according to their residences.Data of gender and residence of children in the 5 age brackets,cause of injury,location of injury,total burn area,wound site,inhalation injury and combined injury,and source of hospitalization expenses of children in the 5 age brackets and two types of residence,and outcome and length of hospital stay of the children were analyzed.The cause of injury of children in different location of injury was analyzed.In addition,they were divided into 2 age brackets:less than or equal to 6 years old and more than 6 years old and less than or equal to 18 years old,and then incidences of hand and foot burn injury were compared.Data were processed with chi-square test,and the correlation between age and total burn area was processed with Spearman correlation analysis.Results Four hundred and forty out of 1 106 inpatients with severe burn were children,accounting for 39.8％ who were included in the system.(1) The majority of children were male (270,61.4％).The number of children more than 1 year old and less than or equal to 3 years old ranked the first (222,50.5％) in the 5 age brackets.The ratio of children from rural areas to that from urban areas was 2.9:1.0.There were no statistically significant differences in both gender and residence of children among the 5 age brackets (withx2 values respectively 7.649 and 9.399,P values above 0.05).(2) Scald was the most common cause of burn.There was statistically significant difference in injury cause of children among the 5 age brackets (x 2 =136.307,P ＜ 0.001).There was no statistically significant difference in injury cause of children among the two types of residence (x2 =5.164,P ＞0.05).(3) Private house was the most common location of injury.There was statistically significant difference in location of injury of children among the 5 age brackets (x 2 =124.930,P ＜0.001).There was no statistically significant difference in location of injury of children among the two types of residence (x 2 =3.364,P ＞ 0.05).There was statistically significant difference in injury cause of children in different location of injury (x 2 =118.284,P ＜ 0.001).(4) Most of children were with total burn areas from 10％ to 39％ total body surface area.There was statistically significant difference in total burn area of children among the 5 age brackets (x 2 =103.568,P ＜ 0.001).There was positive correlation between age and total burn area (r =0.177,P ＜ 0.001).There was no statistically significant difference in total burn area of children among the two types of residence (x 2 =16.213,P ＞ 0.05).(5) Trunk,lower extremity,and upper extremity were the most common wound sites,respectively.There was statistically significant difference in wound site of children among the 5 age brackets (x 2 =45.674,P =0.019).There was statistically significant difference in incidence of hand and foot burn between children less than or equal to 6 years old and children more than 6 years old and less than or equal to 18 years old (withx 2 values respectively 29.188 and 14.612,P values below 0.01).There was no statistically significant difference in wound site of children among the two types of residence (x 2 =8.515,P ＞ 0.05).(6) Twenty-seven children suffered inhalation injury.The main age bracket was more than 12 years old and less than or equal to 18 years old (8 children).The main residence was rural area (18 children).The main cause of inhalation injury was flame burn (23 children).Nine children suffered combined injury,among which the children more than 12 years old and less than or equal to 18 years old accounted for the highest ratio (5 children),and the urban children accounted for higher ratio (5 children).(7) Among the 437 children,most of their hospitalization expenses were at their own expense.There was statistically significant difference in the source of hospitalization expenses of children among the 5 age brackets (x2 =17.917,P =0.001).There was no statistically significant difference in the source of hospitalization expenses of children among the two types of residence (x 2 =0.749,P ＞0.05).(8) Among the 437 children,34 children abandoned treatment and were discharged from hospital,attributed to lack of funding.Seventy-eight children were discharged with a better health condition and 347 were cured.The condition of 6 children worsened and 6 children died.Mean length of hospital stay was 28.6 days for all the children,and 8.8 days for the deteriorated and dead children.Conclusions Children were the major group of patients with severe burn in China.Male children less than or equal to 6 years old were common with scald as the major cause of injury,private house as the major location of injury,and trunk,lower and upper extremity as the most common wound sites,their own expenses as the major source of hospitalization expenses.There were statistically significant differences in cause of injury,location of injury,total burn area,wound site,and hospitalization expenses source of children among the 5 age brackets.