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Volume 39 Issue 10
Oct.  2023
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(10): 968-976
Yang SS,Zhao YY,Luo ZJ,et al.Clinical characteristics and analysis of risk factors for heart injuries in 55 patients with lightning injury on plateau in Tibet Autonomous Region[J].Chin J Burns Wounds,2023,39(10):968-976.DOI: 10.3760/cma.j.cn501225-20230413-00124.
Citation: Yang SS,Zhao YY,Luo ZJ,et al.Clinical characteristics and analysis of risk factors for heart injuries in 55 patients with lightning injury on plateau in Tibet Autonomous Region[J].Chin J Burns Wounds,2023,39(10):968-976.DOI: 10.3760/cma.j.cn501225-20230413-00124.
shu

Clinical characteristics and analysis of risk factors for heart injuries in 55 patients with lightning injury on plateau in Tibet Autonomous Region

doi: 10.3760/cma.j.cn501225-20230413-00124
  • 1.

    Department of Burns, the General Hospital of PLA Tibet Military Area Command, Lhasa 850007, China

  • 2.

    Faculty of Medicine, Tibet University, Lhasa 850033, China

Funds:

Tibet Autonomous Region Natural Science Foundation Project XZ202001ZR0037G

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    Abstract
  •   Objective   To explore the clinical characteristics and treatment outcomes of patients with lightning injury on plateau in Tibet Autonomous Region, and to analyze the risk factors for heart injuries in these patients.   Methods   A retrospective case series study was conducted. From January 2008 to July 2023, 55 patients with lightning injury who met the inclusion criteria were admitted to the General Hospital of PLA Tibet Military Area Command. The gender, age, ethnicity, time of injury, location of injury (average altitude), activity at the time of injury, the occurrence of thermal burns on the body surface, the occurrence of complication, the occurrence of combined injury, underlying disease or physiological process before injury, length of hospital stay, treatment outcome, and effective rate of treatment were recorded. The patients were divided into juvenile group (11 cases), young group (28 cases), middle-aged group (14 cases), and elderly group (2 cases) according to age bracket, then the gender and ethnicity distribution of patients in the 4 groups were compared. According to the occurrence of heart injuries at admission, the patients were divided into heart injury group (44 cases) and non-heart injury group (11 cases), then the gender, age, ethnicity, average altitude of location of injury, length of hospital stay, the occurrence of complication, the occurrence of combined injury, site of thermal burns on the body surface, and area of thermal burns on the body surface in patients were compared between the two groups. Data were statistically analyzed with Mann-Whitney U test, chi-square test, or Fisher's exact probability test. The multivariate logistic regression analysis was conducted to screen the independent risk factors for heart injury in patients with lightning injury.   Results   Among the 55 patients aged 10-68 years, 39 were male and 16 were female, including 47 Tibetans and 8 Hans. There were no statistically significant differences in gender or ethnicity distribution of patients among the 4 groups with different age brackets ( P>0.05). Lightning injuries occurred from May to September, which mostly occurred in June and July. The incidence of lightning injury was higher in Chengguan District of Lhasa City (average altitude of 3 650 m) and Baqing County of Naqu City (average altitude of 4 500 m), being 20.0% (11/55) and 16.4% (9/55), respectively. A total of 96.4% (53/55) of the patients were engaged in outdoor activities when injured, such as grazing, digging Cordyceps, and harvesting highland barley. Among the 55 patients, 46 (83.6%) cases had thermal burns on the body surface, with burn area mainly being not more than 10% total body surface area and burn depth mainly being deep partial-thickness. Fifty-two (94.5%) patients had complications, with heart injury being the most common complication (44 cases, 80.0%). Twenty-two (40.0%) patients had 11 combined injuries, and traumatic brain injury was the most common combined injury. Seventeen (30.9%) patients had 11 underlying diseases or physiological processes before injury. The length of hospital stay of patients was 9 (5, 17) d. Among the 55 patients, 14 cases were cured and discharged, 40 cases were improved, and 1 case died, with effective rate of treatment of 98.2%. Compared with those in non-heart injury group, the proportion of complication occurrence ( χ 2=12.28), the proportion of trunk burns ( χ 2=5.15), and the average altitude of location of injury ( Z=-2.38) of patients in heart injury group were increased significantly ( P<0.05), while there were no significant changes in the other indicators ( P>0.05). Multivariate logistic regression analysis showed that the average altitude at the location of injury was the independent risk factor for heart injury in patients with lightning injury (with odds ratio of 3.28, 95% confidence interval of 1.35-7.99, P<0.05).   Conclusions   Lightning injuries on plateau in Tibet Autonomous Region mainly occur from May to September, with an average altitude of 4 500 m at the location of injury. Patients with lightning injury are injured when participating outdoor activities, and the affected patients are mainly mainly young male Tibetans. Most of the injuries are mild burns. Lightning injuries are complex and have many complications, with heart injury being the most common one. The average altitude at the location of injury is the independent risk factor for heart injury in patients with lightning injury.

     

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    • References(26)
  • [1]
    刘彦宏,郝江. 一起群发23例雷击伤的早期救治及伤情分析[J]. 中华急诊医学杂志,2015,24(9):962-963. DOI: 10.3760/cma.j.issn.1671-0282.2015.09.009.
    [2]
    丁宝财,熊灵,钟鸿烈,等. 364例雷、电烧伤患者并发症探讨研究[J/CD]. 中华损伤与修复杂志(电子版),2010,5(6):783-786. DOI: 10.3877/cma.j.issn.1673-9450.2010.06.018.
    [3]
    van RulerR, EikendalT, KooijFO, et al. A shocking injury: a clinical review of lightning injuries highlighting pitfalls and a treatment protocol[J]. Injury, 2022,53(10):3070-3077. DOI: 10.1016/j.injury.2022.08.024.
    [4]
    BöhrerM, StewartSA, HurleyKF. Epidemiology of electrical and lightning-related injuries among Canadian children and youth, 1997-2010: a Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) study[J]. CJEM, 2018,20(4):586-591. DOI: 10.1017/cem.2017.49.
    [5]
    MutterE, LangleyA. Cutaneous Lichtenberg figures from lightning strike[J]. CMAJ, 2019,191(9):E260. DOI: 10.1503/cmaj.181221.
    [6]
    BlumenthalR. Injuries and deaths from lightning[J]. J Clin Pathol, 2021,74(5):279-284. DOI: 10.1136/jclinpath-2020-206492.
    [7]
    刘瑛琪,钱方毅,李宗浩. 2005年美国心脏学会(AHA)心肺复苏与心血管急救指南解读(十七)电击和雷击[J]. 中国急救复苏与灾害医学杂志,2008,3(2):92-93. DOI: 10.3969/j.issn.1673-6966.2008.02.010.
    [8]
    李华强. 雷电击致小儿烧伤的探讨[J]. 医药产业资讯,2005,2(14):3-4,48. DOI: 10.3969/j.issn.1673-7210.2005.14.002.
    [9]
    文勇. 高原雷击伤大面积烧伤的治疗[J]. 家庭医药,2018(11):27-28. DOI: 10.3969/j.issn.1671-4954.2018.11.030.
    [10]
    白宇,文平,侯晓峰. 电损伤致神经系统损伤致伤机制及临床表现研究进展[J]. 包头医学院学报,2020,36(11):128-132. DOI: 10.16833/j.cnki.jbmc.2020.11.036.
    [11]
    李敬文, 胡永珍, 王开乐, 等. 雷电击伤致基底节区出血2例[J]. 中国临床神经外科杂志, 2017, 22(2): 119-120.DOI: 10.13798/j.issn.1009-153X.2017.02.022.
    [12]
    高小丹,刘涛,罗利琴,等. 雷电击伤致全聋1例及相关知识复习[J]. 西南国防医药,2017,27(3):322-323. DOI: 10.3969/j.issn.1004-0188.2017.03.044.
    [13]
    赵伟豪,索朗杰布,白宗禧,等. 雷击伤致聋2例并文献复习[J]. 中华耳科学杂志,2022,20(3):526-529. DOI: 10.3969/j.issn.1672-2922.2022.03.030.
    [14]
    马荣庆,刘后仓. 雷击性双眼伤一例报告[J]. 眼外伤职业眼病杂志,2004,26(9):645. DOI: 10.3760/cma.j.issn.2095-1477.2004.09.037.
    [15]
    HarrisK, MorrisRE, PatelHR, et al. Bilateral ocular injury from lightning strike[J]. Retina, 2019,39(12):e51-e52. DOI: 10.1097/IAE.0000000000002692.
    [16]
    曲迎军,于红. 雷电击伤引起迟发性心肌损害[J]. 江苏实用心电学杂志,2002,11(2):103. DOI: 10.3969/j.issn.1008-0740.2002.02.015.
    [17]
    李兴德,谭芳. 雷电击伤致急性心肌坏死[J]. 临床心电学杂志,2001,10(4):232. DOI: 10.3969/j.issn.1005-0272.2001.04.024.
    [18]
    叶金善,杨丽霞,陈长征,等. 雷电击伤致缓慢型心律失常的治疗[J]. 西南国防医药,2016,26(5):561-564. DOI: 10.3969/j.issn.1004-0188.2016.05.037.
    [19]
    AydinF, Turgay YildirimO, DagtekinE, et al. Acute inferior myocardial infarction caused by lightning strike[J]. Prehosp Disaster Med, 2018,33(6):658-659. DOI: 10.1017/S1049023X18000705.
    [20]
    张巧玲,王志革,黄凤华. 雷电击伤引起QT间期延长一例[J]. 临床心电学杂志,2004,13(1):47. DOI: 10.3969/j.issn.1005-0272.2004.01.020.
    [21]
    欧毓葵. 雷击伤引起Q-T延长伴QRS低电压1例[J]. 心电学杂志,1996, 15(4):239-240.
    [22]
    雷万军,王肖蓉. 雷电击伤伤情特点及早期救治[J]. 中国现代医学杂志,2002,12(18):30-33. DOI: 10.3969/j.issn.1005-8982.2002.18.012.
    [23]
    RotariuEL, ManoleMD. Cardiac arrest secondary to lightning strike: case report and review of the literature[J]. Pediatr Emerg Care, 2020,36(1):e18-e20. DOI: 10.1097/PEC.0000000000001255.
    [24]
    张新华,郭勇,邓淑娇. 2例雷击致死的法医学鉴定[J]. 中国法医学杂志,2004,19(6):375-376. DOI: 10.3969/j.issn.1001-5728.2004.06.028.
    [25]
    党辉. 雷电击伤并发急性肾功能衰竭、筋膜室综合征1例[J]. 中国冶金工业医学杂志,2009,26(1):23.
    [26]
    王立婧,张晓涤,丁宝财,等. 雷击伤致急性肾衰竭伴多脏器损害1例[J]. 中国血液净化,2009,8(1):56. DOI: 10.3969/j.issn.1671-4091.2009.01.017.
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