小儿烧伤及相关因素的流行病学调查与分析

【目的】了解小儿烧伤的流行病学特征。【方法】对808例小儿烧伤患者的年龄、性别、地域、烧伤时间、月份、地点、致伤因素、部位、程度、院前处理、并发症、转归以及监护人文化程度等因素进行流行病学调查。【结果】808例小儿烧伤患者占同期住院烧伤病人46．12％，烧伤高峰年龄在1～3岁，高发月份1、4、5月份，时间主要分布在18：00-20：00，监护人文化程度、家庭年收入越低，发病率越高，烧伤因素以热水烫伤最为常见（占77．1％），烧伤程度以中度者居多（占50．2％），部位以四肢居多（占56．2％），入院前无处理或非正规处理者非常常见（占95．2％）。随诊375例，后期发生瘢痕增生或瘢痕挛缩畸形者占46．9％。【结论】小儿烧伤是小儿创伤中的常见病与多发病。严重影响小儿的生存质量；加强安全意识及入院前处理，可降低小儿烧伤的发病率以及减轻其损害程度。     

老年糖尿病病人治疗和康复中的几点体会

老年糖尿病病人治疗和康复中的几点体会北京铁路分局中心医院干部病房（北京１０００７１）赵立代卫我国糖尿病患者数量逐年增多。我院干部病房１９８３年１月至１９８７年５月收住糖尿病患者仅１２例次，占同期干部病房总住院人数的１２．６％，平均年龄６８岁，男女之比...     

儿童烧伤原因分析及预防

目的：分析儿童烧伤的原因，根据各年龄段儿童烧伤进行有效预防。方法：选择2005年1月至2006年1月住院的431例儿童病人按各年龄组，男、女比例，烧伤类型，发病季节进行分类分析。结果：各年龄组中0～5岁年龄段儿童烧伤人数为352例，占总人数的81．7％，其中烫伤345例，构成比为98．1％；7例为其它烧伤。5～13岁年龄组中烫伤、火焰、电、化学等烧伤人数为79例，占总人数的18．3％。结论：通过对儿童烧伤原因分析，发现年龄越小烧伤发生率越高，主要是以烫伤为主。     

吕梁市小儿烧伤病因调查及预防

选择1991年1月2008年12月收治的3d～14岁烧伤患儿1130例,占同期住院烧伤患者总数的31％,其中男751例,女379例,死亡8例,病死率为0．7％。本文从小儿烧伤的年龄分布,发病季节,烧伤原因,烧伤面积、部位,以及死亡情况进行调查分析,报告如下。     

老年重症哮喘的治疗

重症哮喘是指哮喘急性发作期的重度和危重度患者出现休息时气短、体位为前弓位、体力活动受限，生活不能自理，夜间不能睡觉。近年来有关老年哮喘的流行病学研究结果证实，〉60岁的老年哮喘发病率为5％～7％，其中2／3左右为新发病例。我院2002年1月至2005年12月收住老年（≥60岁）哮喘患者112例，其中重症哮喘47例，占同期哮喘住院患者的41．2％，现就重症哮喘的早期诊断和治疗体会作总结分析如下。     

急性心肌梗塞111例临床分析

湘雅医院１９７５年８月至１９９３年８月收治急性心肌梗塞（ＡＭＩ）１１１例，该年段ＡＭＩ总发病比例和男性患者比例明显增加。≥７０岁患者比例显著上升。青中年型ＭＩ比例呈增多趋势，且典型胸痛发生率低，首诊非心血管科者占６６．７％。发病６ｈ内入院者占１７．１％，２４ｈ内入院者占４２．３％。总病死率２３．４％，初诊心率≥９０次，同时年龄≥６０岁者病死率显著增高     

家庭暴力烧伤 86例临床和心理情绪特点

家庭暴力是指家庭内（夫妻间、两代人之间）采取的轻重不同的攻击行为。在家庭暴力中,烧伤所致后果具有损伤严重、愈后生存质量差及死亡率高等特点。我所自１９９１～２０００年共收治因家庭暴力所致烧伤患者８６例,治愈率为８９．５％,报告如下。１临床资料本组８６例患者中,男５９例,女２７例,年龄１０～５３岁,烧伤面积６％～９６％TB－SA,平均３８．３％,占同期住院患者的２．５％,死亡９例,死亡率约１０．５％。（１）发生原因分析：８６例家庭暴力烧伤发生的原因主要为婚外情３６例（４１．９％）;经济问题２５例（２９…     

老年脑损伤住院患者流行病学调查及对策分析

目的 调查华山医院神经外科急救中心暨国家老年病中心老年脑损伤住院患者诊治现状及流行病学特征,并为预防和救治老年脑损伤提供参考.方法 对华山医院神经外科急救中心自2005年1月1日至2015年12月31日收治的年龄≥65岁的老年住院患者进行流行病学调查研究,使用SPSS 20进行统计描述、x2检验及Logistic回归分析.结果 1 243例老年脑损伤患者中男女之比为2.42:1,年龄(73.21±6.52)岁,老年患者数量逐年增加.老年患者中急性脑损伤、慢性硬膜下血肿(chronic subdural hematoma,CSDH)、高血压脑出血分别占40.55％、34.75％、9.57％,其中CSDH数量及手术量增长明显.老年人脑损伤主要原因为摔伤(38.94％),而其受伤地点以家中最多(44.65％),其次是公共场所.有基础疾病老年患者数量逐年上升,75.19％的恶化病例和80.39％的死亡病例是由脑损伤相关因素(脑疝等)造成的.患者的入院格拉斯哥意识评分(gasgow coma score,GCS)、年龄、糖尿病史、院内感染以及疾病诊断与预后相关.结论 神经损伤相关疾病的老年患者逐年增多,特别是CSDH.根据老年人受伤情况,应提升家庭及公共场所的安全防护,针对预后相关因素进行重点治疗.     

缓解烧伤患儿操作性疼痛综合干预的研究进展

正烧伤是临床上常见的儿童意外伤害同时在所有的儿童意外伤害之中比例最高,占34%,烧伤儿童占同期住院烧伤患者26.95%~48.16%,以1~5岁最多[1]。美国烧伤协会2013年统计报告显示,16岁以下的儿童占总烧伤住院人数的29%[2]。热液烫伤是最主要的原因[3]。烧伤患儿对疼痛敏感且疼痛承受力差,操作性疼痛作为患儿反复经历的疼痛刺激,也会对其造成一系列近期及远期的不良影响,如生理反     

老年糖尿病病人治疗和康复中的几点体会

我国糖尿病患数量逐年增多。我院干部病房1983年1月至1987年5月收住糖尿病患仅12例次，占同期干部病房总住院人数的12.6％．平均年龄68岁，男女之比为5：1。而1993年1月至1997年5月收住糖尿病患156例次，占周期干部病房总住院人数的28％，平均年龄65岁，男女之比12：1，且复发和加重而再住的增多更为明显。现将我们在近年工作中的儿点体会赍绍于下。     

2002-2010年浙江省宁波市老年人伤害死因和趋势分析

目的 分析2002-2010年宁波市老年人伤害死亡的流行病学特征和变化趋势,为制定老年人伤害预防控制措施提供参考依据。 方法 采用描述性流行病学方法对2002-2010年宁波市60岁老年人死亡登记资料进行统计分析。 结果 宁波市老年人伤害平均死亡率为191.69/10万,标化率为172.87/10万。随着年龄增大,老年人伤害死亡率呈现上升趋势。意外跌落是宁波市老年人伤害的首位死因,死亡率为63.10/10万。农村老年人伤害死亡率(194.96/10万)高于城市老年人(186.14/10万)。女性伤害死亡率(202.40/10万)高于男性(181.07/10万)。城市老年人前4位伤害死因为意外跌落、机动车交通事故、溺水、自杀,农村老年人前4位伤害死因为意外跌落、机动车交通事故、自杀、溺水。男女性前4位伤害死因相同,但顺位略有不同。 结论 伤害已经对宁波市老年人造成健康危害和生命影响,积极开展老年人伤害预防控制工作十分必要。     

Epidemiology of 1974 burn patients at a major burn center in beijing: a nine-year study

To date, little epidemiological data are available on burns in China. This study describes the characteristics of burn patients admitted to a major burn center in Beijing to show trends in admission and outcomes in burned patients to share information about the current state of care for burned patients in our burn center. A retrospective study on 1974 burn patients admitted to Jishuitan Hospital in Beijing was conducted during the 9-year period from 2000 to 2008, and data were collected on age, gender, TBSA, etiology, length of hospital stay, mortality, and inhalation injury. The male:female ratio of the burn population was 2.41:1 and did not differ significantly over the study period (P > .05). The mean age of admission was 36 ± 16.3 years, and most patients were 30 to 39 years old (24.0%) or 20 to 29 years old (23.8%). The mean TBSA of burn was 14.7 ± 3.4%, ranging from 1 to 100%, and the mean size/age did not change significantly over the course of the study (P > .05). The incidence in burn injury decreased over the study period (P < .05). The most common cause of burn was flame (67.9%) followed by electrical (16.1%) and scald (9.5%). The mean length of hospital stay was 33.2 ± 3.5 days, extending from 1 to 413 days, and it did not differ significantly over the study period (P > .05). The mortality and inhalation injury rate were 2.8 and 6.9%, respectively. Annual mortality rate did not differ significantly over the study period (P > .05). This retrospective review of the specific epidemiological features of burn patients will provide important information for the development of proper control programs to reduce the incidence of burns and burn-related deaths.     

A survey of risk factors for burns in the elderly and prevention strategies

Elderly burn patients suffer from greater morbidity and mortality than younger patients with similar burn extents. The purpose of this study was to identify risk factors for burn injuries in the elderly to develop an effective preventive program. A cross-sectional survey was conducted among 20 elderly (> or =65 years of age) burn survivors on the circumstances surrounding their burn injury and on burn prevention. A control group of 20 nonburned elderly completed a similar survey only on burn prevention. The majority of burned subjects believed that their injury was preventable (85%). The home was the commonest location for burn injury (70%), and scalds (50%) and flame burns (25%) were the most common etiologies. Most subjects felt that a burn prevention program would be useful (95%) and television, news, and posters were the preferred sources of prevention information. Compared with the burn group, the control group had more risk factors for burn injury. However, the control group also took more active preventive measures. Burn prevention campaigns for elderly should focus on reducing flame and scald burns that occur in the home, preferably using television, news, and poster media.     

Long-term trends in mortality according to age among adult burn patients

The purpose of this study was to evaluate differences in mortality among adult burn patients over a 25-year period according to age. All patients admitted to a regional burn center between 1973 and 1997 were divided into three age groups (18-34, 35-54, and 55 and older), and mortality rates were compared over time. Between 1973 and 1997, the proportion of patients in each age group remained consistent, as did the type of burns. The average total body surface area burned declined steadily from 31.6% in the 1970s to 18.2% in the late 1990s. The absolute change in mortality was small (7.7%), moderate (16.3%), and large (30.2%) in the young, middle-aged, and old, respectively. However, the relative change demonstrated the opposite pattern. The results of this study suggest that declines in mortality among adult burn patients have occurred across the age spectrum over the past 25 years.     

A seven-year burn unit experience in Kayseri, Turkey: 1996 to 2002

A retrospective multifactorial epidemiological study of 742 patients admitted to Erciyes University Medical Faculty Burn Unit during a 7-year period between 1996 and 2002 is presented. The overall male-to-female ratio was 1.88:1. The highest-risk age group of burn injuries was 0 to 6 years (48.6%), with the greatest number of injuries occurring to children who were 2 to 3 years of age. Seasonal variations had no influence on the increased number of admissions to the burn unit. Scalding was the major cause of pediatric burns. Flame burns were the most frequent cause of burns in adults and the second-leading cause in children. Seventy-eight of the 742 patients died, with a mortality rate of 7.8 % in children and 12.6% and 19.23% in adult males and females, respectively. The overall mortality rate was 10.5%.     

Burn injury in patients with dementia: an impetus for prevention

Current literature has reported an increase in the rates of morbidity and mortality in elderly dementia patients who have suffered from illnesses such as pneumonia or traumatic injuries such as falls, motor vehicle collisions, and other insults. The role of dementia in elderly burn patients has not been studied in depth. To assess the extent of this problem, a retrospective, case-control study of patients with dementia who were admitted to a large urban burn center was performed. The demographics, circumstance and severity of injury, critical care use, and discharge disposition of those patients admitted with dementia were reviewed and compared with the findings of age/burn size-matched controls. The results support the premise that burn injuries in this patient population can be severe. Although not statistically significant, 22.2% of the study group patients required ventilatory support, and 75% required monitoring in the intensive care unit compared with the 15.3% and 61.6% of control patients who required ventilatory support and monitoring in the intensive care unit, respectively. Also, although not statistically significant, the mortality rate of the study group was 25%, almost double that of the control group (13.8%). No other significant differences were observed. These findings support the need for assistance and supervision with daily activity and burn prevention education for this population. As our population ages and we are faced with caring for those with dementia, further burn prevention is warranted.     

2002-2010年浙江省宁波市男性居民前列腺癌死亡趋势分析

目的 分析宁波市前列腺癌死亡的流行病学特征,为进一步开展病因学研究和人群防治工作提供基础资料和参考依据。 方法 收集整理宁波市男性居民2002-2010年前列腺癌死亡报告资料,统计分析各年份粗死亡率和标化死亡率、分年龄别死亡率等。 结果 2002-2010年,宁波市男性居民前列腺癌年平均死亡率分别为3.78/10万,死亡标化率为2.11/10万,呈逐年上升趋势(P0.05);年龄别死亡率均从60岁起明显上升,至85岁组达到高峰,前列腺癌死亡率随年龄增加均呈上升趋势(P0.05);年龄分层后,除15~34岁组外,其余年龄组的不同婚姻状况人群间的总体死亡率存在统计学差异(P0.05),除70~岁组中学和大学文化程度间不具有统计学差异(P0.05)外,其余年龄组间的不同文化程度人群的总体死亡率也存在统计学差异(P0.05)。 结论 随着老龄化社会的到来,前列腺癌带来的社会和生命问题将越来越大。因此,卫生部门应根据前列腺癌发病和死亡的特征,加强前列腺癌的监测工作以及病因学研究,以便开展有针对性的人群的防治工作。     

Burns in octogenarians

Trauma is the fifth leading cause of death for the elderly. Approximately 7.4 million (3% of the population) are more than 80 years old (the so-called "old" old). More than 40% of Americans will reach the age of 80 years, and those who do can expect to live an average of 8 years more. The advanced elderly burn victim creates special demands because of a greater morbidity and mortality associated with a smaller body surface area burn. From September 1982 through August 1990, there were 29 patients 80 years old or older treated at our burn center. The mean age was 83 years, and 72% of the patients were women. The most common preexisting medical problems were hypertension and diabetes. Seventeen (59%) survived. The mean percentage of body surface area (BSA) burned was 6% among the survivors, with a mean length of hospital stay of 24 days. The mean BSA burned was 32% among those who died, with a mean stay of 17 days. Five of the 12 deaths were due to burns of less than 20% BSA, below the standard commonly used to define a "major" burn. The abbreviated burn severity index (ABSI) was a good indicator of survival. Eleven of 12 with an ABSI of 7 or less survived, and nine of 11 with an ABSI of 9 or more died. Twelve patients had operation; seven survived. Of the 15 survivors living independently before the injury, 11 were discharged home and four were transferred to nursing facilities. In this age group, even small burns can be problems, and indications for hospital admission should be broadened. The advanced elderly also cause financial burdens to burn centers because of inadequate diagnosis-related group (DRG) reimbursement. For those surviving, there is a good chance for maintaining independent function and for being discharged home.     

A half-century of burn epidemiology and burn care in a rural state

The aim of this study is to quantify the changes in incidence, severity, and mortality in burn injuries in the state of Maine over the past 50 years from both prevention and treatment perspectives. The authors analyzed the data from multiple sources, including the U.S. Census, death certificates, hospital discharge abstracts, and institutional burn registries in Maine and Boston. The average annual number of burn-related deaths decreased from 53 in 1960-1964 to 14 in 2004-2008. The Maine age-adjusted rate of burn deaths was 8.6% above the national rate in 1960 and 1.4% below it in 2006. The annual number of burn patients admitted to Maine hospitals declined by 65% from 1978 to 2009. Since 1999, 12% of hospitalized patients in Maine were treated in an American Burn Association-certified burn center in Boston. Mortality for Maine burn patients, including those treated at Boston hospitals, is directly related to age and burn severity and similar to stratified mortality in the National Burn Repository. Incidence, severity, and mortality of burn injuries in Maine have decreased dramatically over the past 5 decades. Prevention programs, legislation, and a regionalized system of burn care have all likely contributed to bringing Maine's morbidity and mortality rate below the national average.     

老年人多病因心力衰竭524例临床分析

目的对不同年龄段老年人多病因慢性心力衰竭（CHF）住院病例,进行病因、诱因、伴随疾病和病死率的对比分析,以期为临床老年CHF防治提供参考。方法从住院病例中选出2007年1至12月住院的老年CHF患者524例,以60-69岁、70-79岁和≥80岁分为3个年龄段,比较分析不同的临床特征。结果70-79岁和≥80岁年龄段与60-69岁年龄段相比,病因中冠心病、高血压病、肺心病随增龄增多;诱因中肺炎随增龄明显增多;伴随疾病中糖尿病、慢性肾功能不全、贫血随增龄增多;心律失常无显著差异;病死率随增龄显著增高。结论老年CHF患者的病因、诱因、伴随疾病构成比中,冠心病、高血压病、糖尿病和肺炎随增龄增多。病死率随增龄增高。