蔡立真 廖米荣 孙伟

[摘要] 目的 探討烧伤后脓毒症的影响因素。 方法 选择2019年1—12月我院收治的烧伤患者80例为研究对象。统计脓毒症发生率。记录患者一般资料及临床资料，统计学分析发生烧伤脓毒症的影响因素。 结果 ①80例患者中22例发生脓毒症，发生率为27.50%。②单因素分析结果显示，入院时APACHEⅡ评分>20分、合并慢性病、合并Ⅲ度烧伤、有吸入性损伤、烧伤至入院时间>2 h、首次手术时间>2 d、烧伤面积>50%的患者脓毒症发生率较高（P<0.05）。③多因素分析结果显示，入院时APACHEⅡ评分>20分、合并慢性病、存在Ⅲ度烧伤、有吸入性损伤、烧伤至入院时间长、首次手术时间>2 d、烧伤面积大是烧伤脓毒症的独立危险因素（P<0.05）。 结论 烧伤后脓毒症发生率较高。烧伤深度、吸入性损伤、烧伤面积、烧伤至入院时间、首次手术时间等是发生脓毒症的独立危险因素。

[关键词] 烧伤;脓毒症;吸入性损伤;休克;多脏器功能衰竭

[中图分类号] R644          [文献标识码] B          [文章编号] 1673-9701（2021）08-0099-04

Analysis of the influencing factors of sepsis after burns

CAI Lizhen1   LIAO Mirong1   SUN Wei2

1.Department of Burn， Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University， Taizhou 317000， China; 2.Emergency Center， Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University，Taizhou   317000， China

[Abstract] Objective To explore the influencing factors of sepsis after burns. Methods A total of 80 burn patients admitted to and treated in our hospital from January to December 2019 were selected as the subjects of research. The incidence of sepsis was counted. The general and clinical data of the patients were recorded and the influencing factors of burn sepsis were analyzed statistically. Results ①Sepsis occurred in 22 cases of the 80 patients， with an incidence of 27.5%. ②The results of the single-factor analysis showed that the patients who had a higher incidence of sepsis included those whose APACHE Ⅱ scores were > 20 at the time of admission， those who had a combination with chronic diseases， those who had a combination with third-degree burns，those who had inhalation injury，those whose time from being burnt to being hospitalized was >2 h，those whose time of the first operation was >2 d， and those whose burn area was >50%（P<0.05）.③The results of the multi-factor analysis showed that the independent risk factors for burn sepsis included APACHE Ⅱ scores>20 at the time of admission，a combination with chronic diseases， third-degree burns， inhalation injury，long time from being burnt to being hospitalized，  time of the first operation > 2 d and large burn area（P<0.05）. Conclusion The incidence of sepsis after burns is relatively high. The depth of burns， inhalation injury， burn area， the time from being burnt to being hospitalized and the time of the first operation， etc. are independent risk factors for the occurrence of sepsis.

[Key words] Burns; Sepsis; Inhalation injury; Shock; Multiple organ failure

热力作用于人体所引起的组织损伤统称为烧伤。烧伤与自然灾害、突发事件、生产失误、日常生活等紧密相关，中重度烧伤可导致不同程度的功能障碍，给患者造成经济、精神上的沉重负担，严重影响人们的健康与生活。患者的预后与烧伤程度、烧伤面积、是否合并并发症、基础疾病等诸多因素有关。全身感染、肺部感染等是烧伤常见的并发症，严重者可发生脓毒症[1-2]。烧伤后脓毒症可为细菌或多细菌的混合感染，也可由真菌感染所导致，早期多为单一细菌，晚期可合并混合感染。严重者并发休克以及全身多器官功能衰竭，危及患者生命[3-4]。因此了解烧伤后发生脓毒症的影响因素对预防烧伤后发生脓毒症具有重要的临床意义[5]。本研究分析烧伤后脓毒症的影响因素，以期为临床诊断、预防、治疗提供参考，现报道如下。