Systematic review of the epidemiological characteristics of inhalation injury in burn patients in China
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摘要:
目的 了解我国烧伤患者吸入性损伤的流行病学特征。 方法 采用系统综述的方法。以“吸入性损伤、呼吸道烧伤、喉烧伤”为检索词检索《中国期刊全文数据库》《万方数据库》《中国生物医学文献数据库》,以“burns、inhalation injury”为检索词检索《PubMed》《Embase》数据库,检索各数据库自建库起至2019年1月收录的有关我国烧伤患者吸入性损伤的流行病学特征的回顾性研究。对纳入文献进行数据提取,内容包括第1作者、研究单位、研究年份/年限、研究对象、烧伤患者数、吸入性损伤发生率以及吸入性损伤患者性别、年龄、致伤原因、病死率、死亡原因。 结果 本研究共纳入24篇文献,第1作者来自全国多个单位,为国内多个省/市的重点烧伤救治单位针对1958—2016年收治住院烧伤患者或严重烧伤患者吸入性损伤发生情况进行的单中心或多中心流行病学统计研究,烧伤患者数为103~64 320例。住院烧伤患者吸入性损伤发生率为4.89%~11.28%,未见明显趋势变化;严重烧伤患者吸入性损伤的发生率仍然较高,大部分文献报道为19.09%~32.38%。吸入性损伤患者男性多于女性,男女比为1.61∶1.00~4.95∶1.00;以青壮年为高发人群,致伤原因以火焰烧伤为主。吸入性损伤患者病死率为5.17%~58.67%,其中2000年以来病死率为5.17%~24.75%,各地区医院报道后期病死率较前期有明显下降。吸入性损伤患者的死亡原因有上呼吸道梗阻、脓毒症、呼吸功能衰竭及肺部严重感染。 结论 1958—2016年,我国烧伤患者吸入性损伤发生率未见明显趋势变化;吸入性损伤以青壮年男性为高发人群,致伤原因以火焰烧伤为主,2000年以来的病死率普遍较前期下降。
Abstract:Objective To study the epidemiological characteristics of inhalation injury in burn patients in China. Methods The systematic review method was performed.Chinese Journal Full-text Database,Wanfang Database,andChineseBiomedical Literature Database were searched with the Chinese search terms of "吸入性损伤, 呼吸道烧伤, 喉烧伤", and PubMed and Embase were searched with the search terms of "burns, inhalation injury" to retrieve the collected retrospective studies on the epidemiological characteristics of inhalation injury in burn patients in China from the establishment of each database to January 2019. Data were extracted from the included articles, including the first author, study institution, study period, study subjects, number of burn patients, incidence of inhalation injury, and gender, age, causes of injury, mortality, and causes of death in patients with inhalation injury. Results A total of 24 articles were included in this study with the first authors being from multiple research institutions across the country. The articles reported single or multi-center epidemiological studies with statistics on the incidence of inhalation injury in burn patients or severe burn patients admitted to key burn treatment institutions in many provinces/cities in China from 1958 to 2016. The number of burn patients included was 103-64 320 cases in the studies, and the incidence of inhalation injury in hospitalized burn patients ranged from 4.89% to 11.28%, with no obvious trend. The incidence of inhalation injury in severe burn patients was still high, from 19.09% to 32.38% as most articles reported. The number of men with inhalation injury was larger than that of women, with a male-to-female ratio of 1.61 ∶1.00-4.95 ∶1.00; young and middle-aged people were the high-risk population, and flame burn was the main cause of injury. The mortality of patients with inhalation injury was 5.17%-58.67%, of which the mortality was 5.17%-24.75% since 2000, in accordance with reports from hospitals in various regions that the mortality in the later period decreased significantly compared with the previous period. The causes of death in patients with inhalation injury included upper respiratory tract obstruction, sepsis, respiratory failure, and severe pulmonary infection. Conclusions From 1958 to 2016, there is no obvious trend in the incidence of inhalation injury among burn patients in China; the incidence of inhalation injury is high in young and middle-aged males, and the main cause of inhalation injury is flame burn. The mortality of inhalation injury generally decreased since 2000 compared with the previous period.
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Key words:
- Burns, inhalation /
- Epidemiology /
- Systematic review /
- Incidence /
- Case fatality rate
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