中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2009年
5期
328-331
,共4页
符宜龙%敖晓晓%冉迎春%王昱%许峰
符宜龍%敖曉曉%冉迎春%王昱%許峰
부의룡%오효효%염영춘%왕욱%허봉
自然灾害%创伤和损伤%挤压综合征
自然災害%創傷和損傷%擠壓綜閤徵
자연재해%창상화손상%제압종합정
Natural disasters%Wounds and injuries%Crush syndrome
目的 探讨汶川地震伤后儿童发生CS及其严重程度的相关因素,为临床应对突发灾难事件提供救治方法.方法 回顾性分析我院收治的98例汶川地震伤儿童,统计患儿年龄、性别、被困时间、受伤部位、受伤类型、伤口感染、透析治疗等资料,采用T-test/X2/Fisher精确概率以及Binarylogistic回归分析,对各个可能影响CS发生的相关因素及影响CS严重程度的各个危险因素进行统计分析.结果 15例CS患儿均来自四肢挤压伤患儿,CS在地震伤儿童发生率达15.3%,在四肢挤压伤发生率达25.4%.CS发生的多个相关因素的Binary logistic逐步回归分析中,患儿年龄、被困时间、闭合型挤压伤与CS的发生密切相关,其OR值分别为1.049、1.221、0.068(均P<0.05),而与患儿性别、上或下肢损伤、伤口感染无明显的相关性.各类伤口感染率比较,开放性损伤与CS减张切口感染率明湿高于其他切口,但两组间无统计学意义(P=0.754);在影响CS严重程度的各因素比较发现,CS减张切口感染在影响CS严重程度上有统计学意义(P=0.041).结论 儿童挤压伤后CS的发生主要是四肢损伤为主,与患儿年龄、被困时间以及闭合型挤压伤有关,减张切口感染是影响CS严重度的危险因素.
目的 探討汶川地震傷後兒童髮生CS及其嚴重程度的相關因素,為臨床應對突髮災難事件提供救治方法.方法 迴顧性分析我院收治的98例汶川地震傷兒童,統計患兒年齡、性彆、被睏時間、受傷部位、受傷類型、傷口感染、透析治療等資料,採用T-test/X2/Fisher精確概率以及Binarylogistic迴歸分析,對各箇可能影響CS髮生的相關因素及影響CS嚴重程度的各箇危險因素進行統計分析.結果 15例CS患兒均來自四肢擠壓傷患兒,CS在地震傷兒童髮生率達15.3%,在四肢擠壓傷髮生率達25.4%.CS髮生的多箇相關因素的Binary logistic逐步迴歸分析中,患兒年齡、被睏時間、閉閤型擠壓傷與CS的髮生密切相關,其OR值分彆為1.049、1.221、0.068(均P<0.05),而與患兒性彆、上或下肢損傷、傷口感染無明顯的相關性.各類傷口感染率比較,開放性損傷與CS減張切口感染率明濕高于其他切口,但兩組間無統計學意義(P=0.754);在影響CS嚴重程度的各因素比較髮現,CS減張切口感染在影響CS嚴重程度上有統計學意義(P=0.041).結論 兒童擠壓傷後CS的髮生主要是四肢損傷為主,與患兒年齡、被睏時間以及閉閤型擠壓傷有關,減張切口感染是影響CS嚴重度的危險因素.
목적 탐토문천지진상후인동발생CS급기엄중정도적상관인소,위림상응대돌발재난사건제공구치방법.방법 회고성분석아원수치적98례문천지진상인동,통계환인년령、성별、피곤시간、수상부위、수상류형、상구감염、투석치료등자료,채용T-test/X2/Fisher정학개솔이급Binarylogistic회귀분석,대각개가능영향CS발생적상관인소급영향CS엄중정도적각개위험인소진행통계분석.결과 15례CS환인균래자사지제압상환인,CS재지진상인동발생솔체15.3%,재사지제압상발생솔체25.4%.CS발생적다개상관인소적Binary logistic축보회귀분석중,환인년령、피곤시간、폐합형제압상여CS적발생밀절상관,기OR치분별위1.049、1.221、0.068(균P<0.05),이여환인성별、상혹하지손상、상구감염무명현적상관성.각류상구감염솔비교,개방성손상여CS감장절구감염솔명습고우기타절구,단량조간무통계학의의(P=0.754);재영향CS엄중정도적각인소비교발현,CS감장절구감염재영향CS엄중정도상유통계학의의(P=0.041).결론 인동제압상후CS적발생주요시사지손상위주,여환인년령、피곤시간이급폐합형제압상유관,감장절구감염시영향CS엄중도적위험인소.
Objective To analyze the factors affecting the occurrence and severity of crush syndrome(CS) after crush injury (CI) in pediatric trauma victims in the Wenchuan earthquake. Methods Medical records of 98 patients who were transferred to our hospital were retrospectively reviewed. The risk factors, such as age, gender, time being besieged, type of injury, wound infection, hemodialysis, etc., which were assessed with T-test/X2/Fisher's exact tests and logistic regression analysis for the occurrence of crush syndrome after crush injury. Possible risk factors influencing CS severity were analyzed. Results There were 15 patients with CS, and all these cases were from 59 patients with extremities crush injury. The incidence of CS reached 15.3% in pediatric trauma victims after earthquake and 25.4% in extremities crush injury. Six risk factors were assessed with logistic regression analysis for three outcomes relating to crush syndrome, they are age, time being sieged and closed CI, whose log-odds ratio (log-OR) respectively was 1.049, 1.221, and 0.068 (P<0.05 for all). And no correlation was found between CS and gender, upper or lower limbs injury or wound infection. There was no significant difference in wounds infection rate between patients with open injury and those who underwent CS fasciotomy (P=0.754), but there was significant difference between those patients who underwent CS fasciotomy and those who underwent other operative incisions (P<0.05). Wound infection had a significant association with severity of CS(P=0.041) as compared with other factors such as age, gender, and time being sieged. Conclusion The occurrence of crush syndrome is mainly because of extremities crush injury and also has significant relations with age, time being sieged and closed crush injury in children. Infection of incisional wound after CS fasciotomy is a risk factor for aggravation of CS.