在现代烧伤护理中,儿童患者的烧伤大小和生存概率:一个前性观察队列研究
Robert Kraft1, David N Herndon, Ahmed M Al-Mousawi
1Shriners Hospitals for Children, Galveston, TX, USA.
Lancet (London, England)
|February 3, 2012
概括
烧伤大小超过身体总表面积 (TBSA) 的60%,可显著增加儿科患者的死亡率和发病率. 对于严重烧伤超过60%的儿童,建议提前转移到专门的烧伤中心.
科学领域:
- 儿科烧伤护理 儿科烧伤护理
- 创伤外科 手术 创伤外科
- 关键护理医学 关键护理医学
背景情况:
- 严重烧伤后患者的生存率与烧伤大小有很强的相关性.
- 烧伤护理的进步已经改善了结果,但对儿科患者的大规模分析是有限的.
- 这项研究旨在确定影响儿科患者发病率和死亡率的关键烧伤大小值.
研究的目的:
- 确定与儿科烧伤患者患病率和死亡率增加相关的特定烧伤大小.
- 为了确定燃烧大小的门,这表明不利结果的风险明显更高.
- 为严重烧伤儿童的治疗方案和转移决定提供信息.
主要方法:
- 一个单一中心前性观察队列研究包括952名儿童患者,烧伤≥30%的TBSA.
- 患者按烧伤大小分层,每次增加10% (30-100% TBSA).
- 统计分析包括学生的t测试,奇平方测试,逻辑回归和ROC分析 (p<0.05显著性).
主要成果:
- 随着烧伤的大小,死亡率显著增加,从3% (30-39%的TBSA) 增加到55% (90-100%的TBSA) (p<0.0001).
- 多器官衰竭 (16%) 和败血症 (9%) 的发生率也随着较大的烧伤大小 (p<0.0001) 升级.
- 烧伤大小为62%的TBSA被确定为死亡率的关键值 (OR 10.07,p<0.0001).
结论:
- 在现代儿科烧伤护理中,约60%的TBSA烧伤大小代表了增加发病率和死亡率的关键值.
- 烧伤超过60%的儿童患者应立即转移到专门的烧伤中心.
- 增加警和先进疗法对于烧伤患者至关重要>60% TBSA由于风险增加.
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