烧伤患儿329例流行病学调查及全身炎症反应综合征危险因素分析OACSTPCD

Objective To explore the clinical epidemiological characteristics and risk factors of systemic inflammatory response syndrome(SIRS)in children with burns,so as to provide a reference for the early diagnosis and prevention of SIRS.Methods A retrospective analysis of the clinical data of 329 children with burns who were admitted to the Burn Department of the Second Affiliated Hospital of Kunming Medical University from January 2020 to December 2022 and met the inclusion criteria was conducted using a case-control method.The age,gender,cause of injury,season of injury,total burn area,area of third-degree burns,pre-hospital first aid methods,and first serum examination upon admission of the children were statistically analyzed.The serum markers encompassed C-reactive protein(CRP),Interleukin-6(IL-6),procalcitonin(PCT),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer(DD),and blood glucose level.According to the modified SIRS scoring criteria,the children were divided into a SIRS group(150 cases)and a non-SIRS group(179 cases).An epidemiological survey was conducted and the risk factors for the occurrence of SIRS in children with burns were analyzed.Results(1)The incidence of burns in children aged≥2 and<6 years was the highest in this study.The gender composition ratio of children in each age group was analyzed,and the difference was not statistically significant(χ2=3.480,P=0.326).(2)Moderate burns were the most common,accounting for 217 cases(65.9%).The difference in the degree of burns among age groups was statistically significant(χ2=10.841,P<0.05).(3)There were 277 cases of hot liquid burns(84.2%).The composition ratio of the cause of injury in children of different age groups was analyzed,and the difference was statistically significant(H=49.144,P<0.05).(4)The incidence of burns in children in winter was 30.39%(100/329),which was higher than in other seasons.The distribution of the season of injury in children with burns in different years was analyzed,and the difference was statistically significant(χ2=25.390,P<0.05).(5)Nearly half of the children with burns in this survey did not receive treatment after the burn,accounting for 46.8%.The second most common was improper treatment,accounting for 38%.There were only 50 cases of correct treatment,accounting for 15.2%.In this survey,the number of cases in the group with a time of admission≤8h after injury accounted for more than half,accounting for 66.3%,followed by>12 h and≤24 h,accounting for 15.2%.The proportion of>24 h and≤72 h was the lowest,accounting for only 8.8%.(6)The burn index,blood glucose levels,c-reactionProtein,Interleukin-6,procalcitonin,and prothrombin time were identified as independent risk factors for SIRS in children with burns(all P<0.05),with serological indicators and the burn index showing a positive correlation with the occurrence of SIRS.Conclusion The hospitalized children with burns treated at the Second Affiliated Hospital of Kunming Medical University are mainly boys with moderate hot liquid burns aged over 2 and under 6 years.The combination of serum examination and burn index with the modified SIRS score can improve the specificity of assessing the occurrence of SIRS after burns,and provide a high clinical reference value for the diagnosis and early prevention of SIRS in clinical practice.