目的 分析内蒙古自治区中西部及相关地区儿童烧伤的流行病学特征,为寻找针对性防治措施提供依据. 方法 收集解放军第二五三医院、解放军第三二二医院、内蒙古自治区医院1996年1月-2010年12月住院烧伤儿童病历资料,根据主要致伤原因将病例分为特定因素烧伤组(“锅连炕”构造缺陷导致烫伤,以下称烧伤；简称特因组)和其他原因烧伤对照组(简称对照组).统计2组患儿一般情况、家庭背景、发病周期及病情转归,比较采取“锅连炕”防护措施前后2个时间段(1996-2001年和2002-2010年)流行病学变化趋势.组间比较采用x2检验或秩和检验. 结果 (1)一般情况:共纳入16 595例烧伤儿童,其中热液烧伤15 816例占95.3％,非热液烧伤779例占4.7％.特因组患儿5089例占热液烧伤的32.2％,占烧伤住院儿童总数的30.7％；收治比例以解放军第三二二医院最多,占该院住院烧伤患儿的34.2％ (1803/5267).对照组为11 506例,占烧伤住院儿童总数的69.3％.特因组患儿发病年龄为8个月～5岁,对照组1个月～12岁,2组患儿年龄均以1～3岁居多.特因组男女性别比例为2.1∶1.0,对照组为1.4∶1.0.特因组3590例患儿同时累及多个部位的比例(70.5％,3590/5089),明显高于对照组(54.8％,6311/11 506,x2=361.138,P＜0.01).2组患儿烧伤部位发生率排列顺序相同,从高到低依次是上肢、下肢、头面颈、躯干.特因组烧伤程度总体上重于对照组(Z=27.770,P＜0.01),院前未处理率[31.2％ (1588/5089)]明显高于对照组[24.8％(2857/11 506),x2 =73.010,P＜0.01],冷疗处理率[14.7％ (747/5089)]明显低于对照组[19.6％(2255/11 506),x2=57.636,P＜0.01],伤后6h延迟复苏率[31.5％ (1601/5089)]明显高于对照组[7.8％(897/11 506),x2=1545.234,P＜0.01].(2)家庭背景及发病周期:特因组患儿家庭背景分别为农村67.3％(3424/5089)、乡镇22.1％ (1123/5089)、城市10.7％(542/5089),对照组为农村32.4％ (3727/11 506)、乡镇48.4％(5570/11 506)、城市19.2％(2209/11 506).特因组以当年10月至次年3月为发病高峰期占77.8％(3958/5089),对照组每年5-10月份发病居多[58.2％ (6697/11 506)].(3)病情转归及流行病学变化趋势:特因组患儿治愈率为32.3％(1645/5089),低于对照组的44.7％(5143/11 506,x2=215.615,P＜0.01)；病死率为1.6％(79/5089),高于对照组的0.4％(46/11 506,x2=62.700,P＜0.01).1996-2001年,特因组占热液烧伤患儿的42.5％(2213/5212),对照组占57.5％(2999/5212);采取“锅连炕”防护措施后,2002-2010年,特因组为27.1％ (2876/10 604),对照组为72.9％ (7728/10 604),两个时间段比较差异有统计学意义(x 2 =376.695,P＜0.01). 结论 “锅连炕”构造是内蒙古自治区中西部地区小儿烧伤发病率高的主要因素之一,在锅与炕之间安装防护栏可以明显降低发病率.特殊致伤因素、院前创面处理不正规、休克延迟复苏,是引起患儿致死率和致残率增加的主要原因和今后防治工作的重点.
目的 分析內矇古自治區中西部及相關地區兒童燒傷的流行病學特徵,為尋找針對性防治措施提供依據. 方法 收集解放軍第二五三醫院、解放軍第三二二醫院、內矇古自治區醫院1996年1月-2010年12月住院燒傷兒童病歷資料,根據主要緻傷原因將病例分為特定因素燒傷組(“鍋連炕”構造缺陷導緻燙傷,以下稱燒傷；簡稱特因組)和其他原因燒傷對照組(簡稱對照組).統計2組患兒一般情況、傢庭揹景、髮病週期及病情轉歸,比較採取“鍋連炕”防護措施前後2箇時間段(1996-2001年和2002-2010年)流行病學變化趨勢.組間比較採用x2檢驗或秩和檢驗. 結果 (1)一般情況:共納入16 595例燒傷兒童,其中熱液燒傷15 816例佔95.3％,非熱液燒傷779例佔4.7％.特因組患兒5089例佔熱液燒傷的32.2％,佔燒傷住院兒童總數的30.7％；收治比例以解放軍第三二二醫院最多,佔該院住院燒傷患兒的34.2％ (1803/5267).對照組為11 506例,佔燒傷住院兒童總數的69.3％.特因組患兒髮病年齡為8箇月～5歲,對照組1箇月～12歲,2組患兒年齡均以1～3歲居多.特因組男女性彆比例為2.1∶1.0,對照組為1.4∶1.0.特因組3590例患兒同時纍及多箇部位的比例(70.5％,3590/5089),明顯高于對照組(54.8％,6311/11 506,x2=361.138,P＜0.01).2組患兒燒傷部位髮生率排列順序相同,從高到低依次是上肢、下肢、頭麵頸、軀榦.特因組燒傷程度總體上重于對照組(Z=27.770,P＜0.01),院前未處理率[31.2％ (1588/5089)]明顯高于對照組[24.8％(2857/11 506),x2 =73.010,P＜0.01],冷療處理率[14.7％ (747/5089)]明顯低于對照組[19.6％(2255/11 506),x2=57.636,P＜0.01],傷後6h延遲複囌率[31.5％ (1601/5089)]明顯高于對照組[7.8％(897/11 506),x2=1545.234,P＜0.01].(2)傢庭揹景及髮病週期:特因組患兒傢庭揹景分彆為農村67.3％(3424/5089)、鄉鎮22.1％ (1123/5089)、城市10.7％(542/5089),對照組為農村32.4％ (3727/11 506)、鄉鎮48.4％(5570/11 506)、城市19.2％(2209/11 506).特因組以噹年10月至次年3月為髮病高峰期佔77.8％(3958/5089),對照組每年5-10月份髮病居多[58.2％ (6697/11 506)].(3)病情轉歸及流行病學變化趨勢:特因組患兒治愈率為32.3％(1645/5089),低于對照組的44.7％(5143/11 506,x2=215.615,P＜0.01)；病死率為1.6％(79/5089),高于對照組的0.4％(46/11 506,x2=62.700,P＜0.01).1996-2001年,特因組佔熱液燒傷患兒的42.5％(2213/5212),對照組佔57.5％(2999/5212);採取“鍋連炕”防護措施後,2002-2010年,特因組為27.1％ (2876/10 604),對照組為72.9％ (7728/10 604),兩箇時間段比較差異有統計學意義(x 2 =376.695,P＜0.01). 結論 “鍋連炕”構造是內矇古自治區中西部地區小兒燒傷髮病率高的主要因素之一,在鍋與炕之間安裝防護欄可以明顯降低髮病率.特殊緻傷因素、院前創麵處理不正規、休剋延遲複囌,是引起患兒緻死率和緻殘率增加的主要原因和今後防治工作的重點.
목적 분석내몽고자치구중서부급상관지구인동소상적류행병학특정,위심조침대성방치조시제공의거. 방법 수집해방군제이오삼의원、해방군제삼이이의원、내몽고자치구의원1996년1월-2010년12월주원소상인동병력자료,근거주요치상원인장병례분위특정인소소상조(“과련항”구조결함도치탕상,이하칭소상；간칭특인조)화기타원인소상대조조(간칭대조조).통계2조환인일반정황、가정배경、발병주기급병정전귀,비교채취“과련항”방호조시전후2개시간단(1996-2001년화2002-2010년)류행병학변화추세.조간비교채용x2검험혹질화검험. 결과 (1)일반정황:공납입16 595례소상인동,기중열액소상15 816례점95.3％,비열액소상779례점4.7％.특인조환인5089례점열액소상적32.2％,점소상주원인동총수적30.7％；수치비례이해방군제삼이이의원최다,점해원주원소상환인적34.2％ (1803/5267).대조조위11 506례,점소상주원인동총수적69.3％.특인조환인발병년령위8개월～5세,대조조1개월～12세,2조환인년령균이1～3세거다.특인조남녀성별비례위2.1∶1.0,대조조위1.4∶1.0.특인조3590례환인동시루급다개부위적비례(70.5％,3590/5089),명현고우대조조(54.8％,6311/11 506,x2=361.138,P＜0.01).2조환인소상부위발생솔배렬순서상동,종고도저의차시상지、하지、두면경、구간.특인조소상정도총체상중우대조조(Z=27.770,P＜0.01),원전미처리솔[31.2％ (1588/5089)]명현고우대조조[24.8％(2857/11 506),x2 =73.010,P＜0.01],랭료처리솔[14.7％ (747/5089)]명현저우대조조[19.6％(2255/11 506),x2=57.636,P＜0.01],상후6h연지복소솔[31.5％ (1601/5089)]명현고우대조조[7.8％(897/11 506),x2=1545.234,P＜0.01].(2)가정배경급발병주기:특인조환인가정배경분별위농촌67.3％(3424/5089)、향진22.1％ (1123/5089)、성시10.7％(542/5089),대조조위농촌32.4％ (3727/11 506)、향진48.4％(5570/11 506)、성시19.2％(2209/11 506).특인조이당년10월지차년3월위발병고봉기점77.8％(3958/5089),대조조매년5-10월빈발병거다[58.2％ (6697/11 506)].(3)병정전귀급류행병학변화추세:특인조환인치유솔위32.3％(1645/5089),저우대조조적44.7％(5143/11 506,x2=215.615,P＜0.01)；병사솔위1.6％(79/5089),고우대조조적0.4％(46/11 506,x2=62.700,P＜0.01).1996-2001년,특인조점열액소상환인적42.5％(2213/5212),대조조점57.5％(2999/5212);채취“과련항”방호조시후,2002-2010년,특인조위27.1％ (2876/10 604),대조조위72.9％ (7728/10 604),량개시간단비교차이유통계학의의(x 2 =376.695,P＜0.01). 결론 “과련항”구조시내몽고자치구중서부지구소인소상발병솔고적주요인소지일,재과여항지간안장방호란가이명현강저발병솔.특수치상인소、원전창면처리불정규、휴극연지복소,시인기환인치사솔화치잔솔증가적주요원인화금후방치공작적중점.
Objective To analyze the epidemiological characteristics of pediatric burn in the midwest region of Inner Mongolia and the related areas,and to provide reference for seeking pertinent measures of prevention and treatment.Methods Medical records of patients hospitalized in the 253rd Hospital of PLA,the 322nd Hospital of PLA,and the Inner Mongolia Autonomous Region Hospital from January 1996 to December 2010 were collected.Patients were divided into pediatric burn group with specific reason (group SF,with scald resulted from construction defect of Guo-lian-kang--a heatable brick bed linked to a cooking pot),and burn control group with other causes (group C) according to the main injury cause.Clinical data of patients in both groups,including general condition,family background,occurrence regularity,and outcome,were analyzed.The epidemiological trend of variation before and after taking preventive measures (1996 to 2001 and 2002 to 2010) was compared.Data were processed with chi-square test and rank sum test.Results (1) General condition:out of 16 595 pediatric burn patients,15 816 cases (95.3％) suffered scald due to liquids with high temperature,and 779 cases (4.7％) suffered burns due to other causes.Patients in group SF (scald due to specific cause--Guo-lian-kang) accounted for 32.2％ (5089/15 816) of the total suffered scald by liquids with high temperature,and 30.7％ (5089/16 595) of all the inpatients the cause of burn was related to Guo-lian-kang (group SF).The patients in group SF admitted to the 322nd Hospital of PLA accounted for 34.2％ of all the inpatients admitted to this hospital (1803/5267),more than the other two hospitals in this study.The number of patients in group C was 11 506,accounted for 69.3％ of all the inpatients.The age of patients ranged from 8 months to 5 years in group SF and 1 month to 12 years in group C.The age of the majority of patients ranged from 1 to 3 years in both groups.The ratio of male to female was 2.1∶1.0 in group SF and 1.4∶1.0 in group C.The incidence of scald involving multiple body parts in group SF (3590 cases accounting for 70.5％) was obviously higher than that of group C (6311 cases accounting for 54.8％,x2 =361.138,P ＜ 0.01).In both group SF and group C,the incidence in differ-ent sites was ranked from high to low as follows:upper limbs,lower limbs,the head-face-neck region,and the trunk.The degree of injury in group SF was much more severe than that of group C (Z =27.770,P ＜0.01).The rate of patients without pre-hospital treatment was 31.2％ (1588/5089) in group SF,which was obviously higher than that of group C (24.8％,2857/11 506,x2 =73.010,P ＜ 0.01).The rate of patients treated with cryotherapy was obviously lower in group SF (14.7％,747/5089) than in group C (19.6％,2255/11 506,x2 =57.636,P ＜ 0.01).The rate of patients treated with delayed resuscitation (6 hours after injury) in group SF (31.5％,1601/5089) was obviously higher than that of group C (7.8％,897/11 506,x2 =1545.234,P ＜ 0.01).(2) Family background and occurrence regularity:in group SF,67.3％ (3424/5089) of the patients came from farming area,22.1％ (1123/5089) from villages and towns,and 10.7％ (542/5089) from urban areas.In group C,32.4％ (3727/11 506) of the patients came from farming area,48.4％ (5570/11 506) from villages and towns,and 19.2％ (2209/11 506) from urban areas.Most of the patients in group SF (77.8％,3958/5089) were injured between October and March,while most of the patients in group C (58.2％,6697/11 506) were injured between May and October.(3) Outcome and epidemiological variation:the cure rate of patients in group SF was 32.3％(1645/5089),which was obviously lower than that of group C (44.7％,5143/11 506,x2 =215.615,P ＜0.01).The mortality of patients in group SF was 1.6％ (79/5089),and it was obviously higher than that of group C (0.4％,46/11 506,x2 =62.700,P ＜0.01).From 1996 to 2001,patients in group SF accounted for 42.5％ (2213/5212),while patients in group C accounted for 57.5％ (2999/5212) of the inpatients scalded by hot liquid.After taking preventive measures against injury due to Guo-lian-kang,incidence of scald injury in group SF was lowered to 27.1％ (2876/10 604),while the incidence in group C remained at 72.9％ (7728/10 604) of the inpatients with hot liquid scald from 2002 to 2010.The difference between the two periods was statistically significant (x2 =376.695,P ＜ 0.01).Conclusions The defect of construction of Guo-lian-kang is one of the main factors that lead to a high incidence of pediatric burn in the midwest of Inner Mongolia.Installation of a protective bannister between the cooking pot and the " kang (heatable brick bed) " can obviously reduce the incidence of scald injury.Special injury-causing factors,unprofessional pre-hospital treatment of the wound,delayed resuscitation after shock are the main causes of increasing mortality and disability,and they constitute the key targets of prevention and treatment of such injury in future.
