镇江地区五年来职业烧伤回顾性调查

对镇江地区１９８６－１９９１年２２１例职业烧伤病便进行了分析总结。本组平均年龄３１．２岁，男性占８３．４％，７９．６％的病人在伤后２４ｇ内入院。首位致伤原因为火焰（３３％）。平均烧伤面积１７．１％。平均Ⅲ度面积８．１％。８．１％的病人并发吸入性损伤。本组死亡率为１．８％。平均住院时间３４．３天，平均初步住院费用３千余元。文章强调对职业烧伤的现场急救和正确的早期处理，讨论了降低职业烧伤发病率的初步设     

1748例烧伤病例分析

我院自 １９９０年 １月至１９９６年１２月，共收治烧伤病人１７４８例，现统计分析如下。１临床资料１.１一般资料本组 １７４８例中，男 １２４６，女５０２，男女之比为２．４８：１，以５岁以下儿童发病率最高，占４３．８７％，其次是２１－３０岁者。发病季节以７、８、９三个月发病率最高，占全年的２９．３％。致伤原因主要为热力烧伤，占８６．０７％，其次为化学烧伤和电烧伤，分别占２．４６％和２．１２％。烧伤程度：轻度烧伤５５３例，占３１．６％，中度烧伤７１８例，占４１．１％，重度烧伤２８０例，占１６％，特重度烧…     

大面积深度烧伤休克期切痂植皮

目的 探讨大面积深度烧伤休克期切痂植皮的必要性和可行性。方法 自１９９１年１月至１９９７年６月选择伤后及时入院的１２例病人，烧伤面积平均７８．３％±１８．３，Ⅲ度面积平均６９．２％±２６．８％，其中６例合并吸入性损伤，３例气管切开。开始手术时间为伤后３８．４±９．６小时，一次切痂面积３９．３％±８．７％，以尿量、心率、ＳａＯ２和ＣＶＰ为主要监护指标。结果 术中术后各监护指标都较平稳。与条件相似的１     

严重烧伤早期心肌细胞内K~＋浓度和细胞膜Na~＋－K~＋－ATP酶活性的变化

为探讨严重烧伤后早期心肌细胞内Ｋ＋浓度的变化及其机制，采用Ｋ离子选择微电极技术，测定了大鼠３５％ＴＢＳＡⅢ度烧伤后第１、３、８和２４小时心室乳头肌细胞内Ｋ＋活度（并换算成浓度），同时测定了伤后８小时心肌细胞膜ＡＴＰ酶活性。结果表明：①严重烧伤后２４小时心肌细胞内Ｋ＋浓度均下降，伤后第１、３、８和２４小时分别降为正常值的９６．２％±１．３％、８５．８％±１．３％、６５．９％±１．０％和７３．７％±１．１％。伤后８小时达最低值，２４小时有所恢复，但仍低于伤后３小时水平；②伤后８小时心肌细胞膜总ＡＴＰａｓｅ，Ｍｇ２＋－ＡＴＰａｓｅ和Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ活性均降低。提示：烧伤促进Ｋ＋外流，抑制Ｋ＋内流，且烧伤后Ｋ＋内流减少与心肌细胞膜Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ活性显著降低有关。     

大面积深度烧伤休克期切痂植皮

目的探讨大面积深度烧伤休克期切痂植皮的必要性和可行性。方法自１９９１年１月至１９９７年６月选择伤后及时入院的１２例病人，烧伤面积平均７８．３％±１８．３％，Ⅲ度面积平均６９．２％±２６．８％，其中６例合并吸入性损伤，３例气管切开。开始手术时间为伤后３８．４±９．６小时，一次切痂面积３９．３％±８．７％，以尿量、心率、ＳａＯ２和ＣＶＰ为主要监护指标。结果术中术后各监护指标都较平稳。与条件相似的１９例非休克期切痂病人对比表明：休克期切痂病人愈合天数缩短１４天左右，内脏并发症及菌血症发生率低，治愈率高，平均每日住院费用降低。结论休克期大面积切痂植皮是可行的     

高原地区严重烧伤病人的血气分析

高原地区严重烧伤病人的血气分析李海林王庆明亓伟明１９８９年９月至１９９３年１２月，对我科收治的２４例严重烧伤病人进行了系统的血气分析。资料与方法本组男性１８例，女性６例；平均烧伤总面积５８．１％±２１．５％，平均Ⅲ度面积４４％±２０．０％；当地生长者１３例...     

镇江地区五年来职业烧伤回顾性调查

对镇江地区1986～1991年221例职业烧伤病例进行了分析总结。本组平均年龄31.2岁,男性占83.4%,79.6%的病人在伤后24 h 内入院。首位致伤原因为火焰(33%)。平均烧伤面积17.1%,平均Ⅲ度面积8.1%。8.1%的病人并发吸人性损伤。本组死亡率为1.8%。平均住院时间34.3天,平均住院费用3千余元。文章强调对职业烧伤的现场急救和正确的早期处理,讨论了降低职业烧伤发病率的初步设想,旨在为劳保部门和其它地区职业烧伤研究提供参考。     

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目的 探讨直肠癌术后下肢深静脉血栓形成（ＬＤＶＴ）的原因及其防治。方法 回顾性研究自１９９１年１月至１９９９年６月间收治的８全针肠癌术后ＬＤＶＴ病人。结果 本组ＬＤＶＴ占同期深静脉全形成的２．１％（８／３８４）。占同期直肠癌手术治疗的１．２％（８／６５６）。左侧５例，右侧３例。术后早期发生的ＬＤＶＴ有７例，均为截石体位手术，平均发生于术后第１０天，另１例２年发生。本组病人早期祛聚、抗凝和溶栓治疗后     

小儿烧伤惊厥的预防和处理

小儿烧伤惊厥的预防和处理李毅聂兰军高智仁惊厥是小儿烧伤后常见并发症之一。我院１９８６年１月～１９９３年１２月共收治小儿烧伤６５０例，共发生惊厥１１例，占１．７％。临床资料一、一般资料本组共６５０例，住院期间发生惊厥１次以上者１１例。男性８例，女性３例...     

肺转移瘤的外科治疗

报告３７例肺转移瘤的外科治疗，６７．５％的病人无症状，均在原发瘤术后随诊作Ｘ线胸片或胸透时发现，部分病人有咳嗽，咯血，胸闷和胸痛。本组手术死亡率５．４％，住院死亡率２．７％，术后１、３、５和７年生存率分别为９１．８％，４３．３％，３６．８％和２１．４％，讨论了肺转移瘤的诊断，治疗及预后，作者认为对肺转移瘤外科治疗应持积极态度。     

Chemical burns: our 10-year experience.

A review of 173 patients with chemical burns admitted to our burn unit was carried out during the years 1976-85. Most burns were work related (83 per cent). The majority of patients were men aged 21-50 years (mean age = 29.6 years). The mean total body surface area involved was 3.6 per cent (range = 1-30 per cent). The mean length of stay in hospital was 6.3 days (range = 1-52 days). The extremities were involved in 68 per cent of the patients. The more common aetiological agents were bromine and its compounds (36 per cent), then acids (21 per cent), alkalis and organic substances (14.5 per cent each). The severest burns were caused by the inorganic substances. Delayed admission was most characteristic of the bromine and alkali burns. Complications included local infection (19 cases), systemic infection (two cases), inhalation injury (two cases), tissue necrosis (one case) and corneal erosion (one case). There were no deaths. Increased awareness of the hazardous potential of chemicals should help reduce the incidence of chemical burns.     

Burn injury and management in Liberia

Burn care in developing countries remains a challenge. This paper reviews the acute burn care of 21 patients admitted during a 1-year period to a hospital in Liberia. Lack of supplies and education, coupled with the local belief system, reflect on patient management. The study population to falled 21 patients, ranging from 1 to 62 years of age. TBSA burns ranged from 2 to 60 per cent (mean 21 per cent), 61 per cent of patients were grafted. The time between burn and graft varied between 5 and 96 days (mean 29.8). Graft take varied between 40 and 100 per cent (mean 81 per cent). Of the grafted patients 66.6 per cent received blood (average 732 ml). At the time of presentation 61.9 per cent of patients had other illness. The average number of hospital days was 37.9 (range 2–76). The mortality rate was 14.2 per cent. When managing burns in a developing country, adaption of a simple, clearly defined method of treatment, together with education of the caregivers, is suggested. As in the developed world, however, prevention is the critical factor.     

An analysis of burn mortality: a report from a Spanish regional burn centre

This paper reports an analysis of the mortality rates and related factors in our Burn Centre, based on 710 patients treated between 1985 and 1988. The average age of the patients was 23.8 years and the average burn size was 14 per cent of the body surface area. Burning injury affected mainly men (66 per cent), and their mortality rate was higher than that of women. The overall mortality rate was 6.6 per cent, the average age of the fatally injured patients being 54 years. We confirm that mortality in burned patients is closely related to: age (51 per cent of the patients were over 60 years of age); burn size (68 per cent of the patients had burns covering more than 30 per cent TBS); burn depth (57.4 per cent had full skin thickness burns); inhalation injury (present in 66 per cent of the fatally injured); and associated risk factors. The main cause of the burning injury was flames, chiefly from domestic accidents. The average survival time for the fatally injured patients was 10 days. Finally, our expected mortality followed a linear regression model, the LA50 for patients with only full skin thickness burns was 50 per cent.     

Northeastern Ohio Trauma Study: V. Burn injury

Burn injury cases were identified from a population-based sample of trauma visits to hospital emergency departments in northeastern Ohio during 1977. The 199 cases represented 2.4% of all trauma incidence visits by residents of the five-county study region. Ninety-five per cent of the burn cases were released from the emergency department directly after treatment. The annual incidence rate of emergency department-treated burns was 4.7 per 1,000 population. Incidence rates for males were twice those for females. The age groups with the highest annual incidence rates were those under 5 years of age and 25-34 years (seven and eight cases per 1,000 population, respectively). Most burns occurred at home or the workplace. The youngest employed age group sustained the highest rate of work-related burns. Hot or corrosive substances caused two thirds of all burns; fire and flames caused one fourth.     

Analysis of 155 patients with chemical injury: a 5-year experience

From July 1986 to June 1991, 155 patients were treated in our department for various chemical burn injuries. The experience over the 5-year period is reviewed. Among these patients, 109 patients were between 20 and 40 years of age and accounted for 70.3 per cent of all chemical burn patients. It is suggested that chemical burns are very common in people of working age. Chemical burn manifestations were unlike those of thermal injury. The scene of injury, type of chemical agent, age of patients, clinical manifestation and management of the burn surface are discussed. Although the patients were given the same physical therapy, early tangential or full thickness excision and immediate autografting yielded better results than conservative treatment and shortened hospital stay.     

An epidemiological study of burn patients hospitalized in Valencia, Spain during 1989.

A retrospective study has been made of the patients hospitalized in the Burn Centre of La Fe Hospital in Valencia (Spain) during 1989. Of the 1825 patients seen during this period, 146 (8 per cent) were admitted to hospital. The mean patient age was 31.42 years, 68.5 per cent of the patients were male; 34.1 per cent were children under the age of 15 years and 15 per cent were over 60 years old. Fire was the most common cause of burns (50 per cent), and produced the most extensive lesions. Electrical current and firm contact with hot surfaces caused deeper burns. Thermal lesions were most frequently produced within the domestic environment. Burns caused by fire affected mainly the head and neck, scalding tended to involve the trunk and electrical current caused injury to the limbs. Half the hospital admissions were discharged within 15 days. Most of the lesions requiring hospital admission occurred during the winter months.     

Analysis of 105 patients admitted over a 2-year period to a modern burns unit in Saudi Arabia

This is an epidemiological survey of 105 burned patients treated between May 1986 and May 1988 in a modern Burns Unit in Saudi Arabia. Hospitalization time ranged from 1 to 100 days with a mean of 17 days. The mean age of the patients was 9 years. Sixty (57 per cent) of the patients were males and 45 (43 per cent) were females. The main causes of injury were hot liquids (57.7 per cent) and fire (33 per cent). The mean extent of injury was 19 per cent TBSA. Burns covered less than 40 per cent TBSA in 91 out of 105 patients (87 per cent). Deep burns did not exceed 100 units of burned skin in 48 out of 55 patients (87 per cent). Urgent escharotomy was done in 14 patients. Early excision and skin grafting was carried out in 34 patients. Complications included six cases (5.7 per cent) with septicaemia, one (0.9 per cent) with disseminated intravascular coagulopathy, three (2.9 per cent) with amputation and one (0.9 per cent) with stress gastric ulcer. Seven patients discharged themselves against medical advice. Five patients died. The favourable results in this series were attributed mainly to the low severity of burns and partially to the short delay between injury and admission, early surgery and remarkably good facilities. Childhood scalds in this region of the world could possibly be reduced by changing the family habit of having tea at floor level and recommending wide-based tea-pots.     

Work-related burns: a 6-year retrospective study

During the 6 years from July 1984 to May 1990, 193 patients (30.2 per cent of all patients) were admitted to our regional adult burn centre, for treatment of work-related burn injuries. The median age of patients was 32.5 years (range 18-64 per cent), and 94 per cent were males. Fifty-nine per cent of the patients came from metropolitan Toronto, and 40 per cent from rural Ontario. Most of the patients (97.3 per cent) were referred to the burn centre within 24 h of their injury. The most common aetiology was electrical injury (29.5 per cent), followed by flame (24.4 per cent), contact (10.4 per cent), flash (9.8 per cent), tar and asphalt (9.3 per cent), scald (7.8 per cent), chemical (5.1 per cent), steam (4.7 per cent) and grease (1 per cent). Within the electrical burn group, about one-half were flash burns, one-quarter were clothing fire injuries, and one-quarter were contact injuries. These occupational burns tended to be extensive injuries. The median body surface area (BSA) was 16.5 per cent, with a median full thickness (FT) component of 5.0 per cent. The average length of stay was 20.0 days. Inhalation injury requiring intubation occurred in 14.8 per cent of patients. Sepsis--confirmed by positive blood cultures--developed in 14 per cent of the patients, at an average time of 8.8 days postburn. Staphylococcus aureus was the commonest organism isolated from blood cultures. Pneumonia occurred in 6.3 per cent of patients. A total of 207 surgical procedures was performed on 113 of the 193 patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Epidemiology of industrial burns in Brisbane

A retrospective epidemiological study of industrial burns admitted to the Royal Brisbane Hospital was conducted over a period of 7 years. A total of 182 patients were included in this survey--173 males (95 per cent) and 9 females (5 per cent). The proportion of industrial burns has decreased from 31.5 per cent to 18.5 per cent of total admissions to the burns unit over the past 10 years. Fifty per cent of the burns occurred in males less than 30 years old. The average age was 31 years. Two-thirds of the burns covered less than 10 per cent of the body and 84 per cent covered less than 20 per cent. While scalds were the commonest cause of industrial burns in our study (19.4 per cent), flame burns with clothing ignited caused the most extensive burns. Face and hands were the most common sites involved. Burns to these regions were mainly caused by flame and electrical burns. Eye burns comprised 5.5 per cent of the sample and were due to chemicals, gas explosions and electric flash. Twenty-six patients (14 per cent) suffered respiratory injury. Only one patient out of our series of 182 died. Progress has been made in industrial safety in the past few years but carelessness and human error still take their toll.