严重烧伤患者脓毒症并发情况及其影响因素分析

摘要

Objective To investigate concurrent situation of sepsis and influencing factors of patients with sever burn in order to decrease death rate.Methods A total of 495 patients with sever burn during May 2015 and February 2016 were divided into sepsis group (n =180),who had serious burn combined with sepsis,and non sepsis group (n =315).Age,gender,burn area,whether or not inhalation injury,injury causes,time of admission,the first time of operation were possibly relevant factors affecting sepsis pathogenesy.Relations between different burn areas and sepsis pathogenesy were compared.Results There were significant differences in the time of admission,burn area,whether or not combined with inhalation injury and the first time of operation between the two groups (P ＜ 0.01).In sepsis group,number of patients with burn area equal or less than 50％ of total body surface area (TBSA) was less,and number of patients with burn area 51％-80％ and above 80％ of TBSA was higher than those in non sepsis group (P ＜0.01).Burn area more than 51％ TBSA,the first time of operation more than 2d or without surgical treatment were independent risk factors for patients with combination sepsis (P ＜ 0.01).Conclusion Influencing factors of combination sepsis of patients with sever burn are burn area and the first time of operation,and it shows that timely therapy may avoid incidence of sepsis.%目的 研究严重烧伤患者脓毒症并发情况,探讨影响脓毒症发病的因素,降低患者的死亡率.方法 选取2015年5月-2016年2月收治的495例严重烧伤患者,其中严重烧伤并发感染脓毒症的患者180例为脓毒症组,剩余315例烧伤患者为非脓毒症组,研究年龄、性别、烧伤面积、有无吸入性损伤、烧伤原因、入院时间、首次手术时间等7个可能影响脓毒症并发的相关因素,并比较不同烧伤面积与脓毒症的发病关系.结果 两组的入院时间、烧伤面积、是否合并吸入损伤及首次手术时间比较差异有统计学意义(P＜0.01).脓毒症组烧伤面积为≤50％总体表面积(TBSA)患者少于非脓毒症组,烧伤面积为51％～80％和＞80％ TBSA的患者多于非脓毒症组(P＜0.01).烧伤面积≥51％ TBSA、首次手术时间＞2d或未行手术治疗是并发脓毒症的独立危险因素(P＜0.01).结论 影响严重烧伤患者脓毒症发病的因素包括烧伤面积与首次手术时间,提示及时治疗可能避免脓毒症发生.