Objective: To investigate the epidemiological characteristics of hospitalized pediatric patients with burns and explore the prevention and treatment strategy of pediatric burns. Methods: Medical records of pediatric burn patients hospitalized in multiple departments of Children's Hospital of Chongqing Medical University from January 2012 to December 2016 were retrospectively analyzed. Data including gender, age, residence, ways of paying, total burn area, burn severity, cause, time, and place of burns, prehospital treatment ways, clinical outcome, length of hospital stay were collected and processed with chi-square test, Kruskal-Wallis H test, and Bonferroni correction. The factors which influence wound healing were processed with multivariate logistic regression analysis. Results: (1) A total of 1 946 pediatric burn patients with complete medical records were hospitalized in Children's Hospital of Chongqing Medical University during the 5 years, with 1 127 boys (57.91%), which were more than 819 girls (42.09%). Pediatric patients≤3 years old were with the highest incidence of burns of 87.15% (1 696/1 946). There was no significantly statistical difference in gender composition ratio among pediatric patients of different ages (χ2=2.294, P= 0.318). (2) The residence of 1 536 pediatric patients (78.93%) were in town, and most of them used urban resident essential medical insurance for medical cost. Most of the pediatric patients living in rural areas paid the medical cost at their own expense. There was significantly statistical difference in way of paying between pediatric patients living in urban and those in rural areas (χ2=658.324, P<0.05). (3) The pediatric patients with total burn surface area≥5% total body surface area (TBSA) and<15% TBSA were the most (1 200 cases, accounting for 61.66%). The pediatric patients with moderate burns were the most (1 225 cases, accounting for 62.95%), followed by mild burns (494 cases, accounting for 25.39%), severe burns (124 cases, accounting for 6.37%), and extremely severe burns (46 cases, accounting for 2.36%). (4) The pediatric patients with scald caused by hot water were the most (1 801 cases, accounting for 92.55%), followed by flame burns (69 cases, accounting for 3.55%), chemical burns (44 cases, accounting for 2.26%), and electrical burns (32 cases, accounting for 1.64%). There was significantly statistical difference in cause of injury among pediatric patients of different ages (χ2=85.471, P<0.05). (5) The incidence of burns of pediatric patients in Spring was 27.95% (544/1 946), which was slightly higher than those in other seasons. There was significantly statistical difference in the burn season among pediatric patients admitted to the hospital in different years (χ2= 23.172, P< 0.05). As to burn place, most of burns of pediatric patients happened at home (1 776 cases, accounting for 91.26%). (6) There was significantly statistical difference in clinical outcome among pediatric patients with different prehospital treatments (H=16.005, P<0.05). There was significantly statistical difference in clinical outcome between pediatric patients with reasonable prehospital treatments and those with unreasonable prehospital treatments (H=-64.990, P<0.05), and between pediatric patients with reasonable prehospital treatments and those without any treatment (H=-74.775, P<0.05). There was no significantly statistical difference in clinical outcome between pediatric patients with unreasonable prehospital treatments and those without any prehospital treatment (H=-9.785, P>0.05). (7) The median of length of hospital stay of pediatric patients was 8 days. The pediatric patients with length of hospital stay≤7 days were the most (834 cases, accounting for 42.86%), and the pediatric patients with length of hospital stay>30 days were the least (39 cases, accounting for 2.00%). (8) The way of prehospital treatment and cause of injury were independent risk factors influencing wound healing (χ2=7.946, 12.977, P<0.05). With no prehospital treatment as benchmark, reasonable prehospital treatments promoted wound healing (odds ratio=1.662, 95% confidence interval=1.129-2.447, P<0.05). With chemical burns as benchmark, electrical burn wounds were harder to heal (odds ratio=0.144, 95% confidence interval=0.028-0.734, P<0.05). Conclusions: Pediatric burn patients hospitalized in Children's Hospital of Chongqing Medical University were mainly boys≤3 years old with moderate scald caused by hot water at home in urban areas. Timely and reasonable prehospital treatments are beneficial to wound healing.
目的： 分析住院烧伤患儿临床流行病学特征，探讨儿童烧伤的防治对策。 方法： 回顾性分析2012年1月—2016年12月重庆医科大学附属儿童医院多个科室收治的住院烧伤患儿的病历资料，统计患儿性别、年龄、居住地、缴费方式、烧伤总面积、严重程度、致伤原因、致伤时间和地点、院前处理方式和临床转归、住院时间。对数据进行χ2检验、Kruskal－Wallis H检验、Bonferroni校正，并对影响创面愈合的因素进行logistic回归分析。 结果： (1)重庆医科大学附属儿童医院5年间收治1 946例病历资料完整的住院烧伤患儿，其中男童1 127例(57.91%)，多于女童的819例(42.09%)；本组≤3岁患儿烧伤发生率最高，为87.15%(1 696/1 946)。各年龄段患儿性别构成比比较，差异无统计学意义(χ2＝2.294，P＝0.318)。(2)1 536例(78.93%)患儿居住在城镇，其中大部分使用城镇居民基本医疗保险，而居住在乡村的绝大部分患儿自费就医。不同居住地患儿缴费方式比较，差异有统计学意义(χ2＝658.324，P<0.05)。(3)烧伤总面积≥5%体表总面积(TBSA)且<15%TBSA患儿最多，共1 200例(61.66%)。中度烧伤患儿最多，共1 225例(62.95%)，其次为轻度烧伤494例(25.39%)、重度烧伤124例(6.37%)、特重度烧伤46例(2.36%)。(4)热液烫伤患儿最多，共1 801例(92.55%)，其次为火焰烧伤69例(3.55%)、化学烧伤44例(2.26%)、电击伤32例(1.64%)。各年龄段患儿致伤原因比较，差异有统计学意义(χ2＝85.471，P<0.05)。(5)患儿春季烧伤发生率为27.95%(544/1 946)，稍高于其他季节。不同年份入院患儿烧伤发生季节比较，差异有统计学意义(χ2＝23.172，P<0.05)。患儿烧伤主要发生于家中，共1 776例(91.26%)。(6)不同院前处理方式患儿临床转归情况比较，差异有统计学意义(H＝16.005，P<0.05)。合理院前处理与不合理院前处理患儿临床转归比较，差异有统计学意义(H＝－64.990，P<0.05)；合理院前处理与院前未处理患儿临床转归比较，差异有统计学意义(H＝－74.775，P<0.05)；不合理院前处理与院前未处理患儿临床转归比较，差异无统计学意义(H＝－9.785, P>0.05)。(7)患儿住院时间中位数为8 d，住院时间≤7 d患儿最多，为834例(42.86%)；>30 d患儿最少，为39例(2.00%)。(8)院前处理方式和致伤原因是影响患儿创面愈合的独立危险因素(χ2＝7.946、12.977，P<0.05)。以院前未处理为基准，合理院前处理促进创面愈合(比值比为1.662，95%置信区间为1.129～2.447，P<0.05)。以化学烧伤为基准，电击伤创面更不易愈合(比值比为0.144，95%置信区间为0.028～0.734，P<0.05)。 结论： 重庆医科大学附属儿童医院收治的住院烧伤患儿主要为城镇地区3岁及以下室内中度热液烫伤男童，及时合理的院前处理有利于创面愈合。.
Keywords: Burns; Child; Epidemiology.