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中重度燒傷患童的年齡、發生原因與場所之探討

An Investigation of Age, Causes and Locations Associated with Moderate to Severe Burns in Infants and Young Children

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摘要


本文之研究目的針對燒燙傷類別、發生原因與場所進行探討,並找出住院天數的預測因子。研究對象來自高雄國軍左營醫院燒傷中心。研究方法是從1998年6月1日至2000年5月31日兩年時間內,共收集53位12足歲以下的中度與重度燒傷患童,依年齡又分為三組:分別為嬰幼兒期(0-3歲,不含3歲;<3歲)、學齡前期(3-6歲,不含6歲,<6歲)和學齡期(6-12歲)。 結果發現燒傷類型以燙傷和火燒傷為主,各佔75.5%及24.5%。其中小於3歲嬰幼兒的比例最高。男女比為2.3:1。在燙傷方面,被熱湯燙到佔最高比例(57.5%),次為熱開水(37.5%)與洗澡水(5.0%)。火傷方面以酒精爐燃燒最多(46.2%),鞭炮(30.8%) 與火災(23.0.%)次之。發生地點在家中者共計33位(62.3%),戶外有20位(37.7%)。家中發生的地點以客廳最多(39.4%),次為臥室(30.3%)和廚房(21.2%)。戶外以餐館最多(40%),其次是住家庭院(30%)。因自己不小心而造成燒燙傷者有38人(71.7%),他人非故意者有15人(28.3%)。 本文結論為小於3歲患童的燙傷比例顯著高於3-12歲,而3-12歲是以火傷為主。同樣的,小於3歲患童於家中發生燒傷的比例顯著高於3-12歲,但3-12歲患童最容易受傷的場所是戶外。另外,小於3歲嬰幼兒的燒傷事件是由於自己不小心而造成。相反的,大多數6-12歲患童的燒傷是由他人非故意所造成。最後,燒傷面積與燒傷類型是住院天數的重要預測因子,共可解釋總變異量的70.8%。本研究結果可讓從事燒傷復健的專業人員、父母及主要照顧者更了解燒傷的危險因子,以有效地及早預防並進行安全教育之宣導。

並列摘要


The purposes of this study were to investigate the circumstances of occurrences in 53 patients with moderate to severe burns under 12 years of age, who were admitted to the burn center of the Armed Forces Tsoying Hospital in Kaohsiung from June 1998 to May 2000. The subjects were further divided into three age groups: 0-3 years, 3-6 years, and at least six but less than twelve years old for pairwise comparisons purpose. The results showed that the overall ratio of male to female was 2.3. Scalds accounted for 75.5% of all burns, whereas the remaining 24.5% were ascribed to flame burns. The majority of childhood burn injuries happened to children under 3. Hot liquids were the most frequent cause of scalds, explaining 57.5% of all scalds, and that hot water was the next highest. In terms of flame burns, alcohol burning stove (46.2%) was the commonest agent followed by firecrackers (30.8%) and fires (23.0%). Most burn injuries (62.3%) occurred at home, while the remaining 37.7% of injuries occurred outside the home. The living room (39.4%) was the commonest room where scalding was the mode of injury, followed by bedroom (30.3%) and kitchen (21.2%). Accidents outside the home most commonly took place in restaurants (40%) and backyard (30%). 71.7% of burns were self-induced out of ignorance, whereas 28.3% of burns were caused by others unintentionally. There was a statistically significant difference in the age groups according to the places in which the burn injury occurred, with children aged 3-12 years burned more frequently outside the home compared with 0-3 years age group. Likewise, significant differences emerged in the age groups as a function of the types of burn, with 0-3 years age group suffered more from scalds than flame burns in comparison to children aged 3-12. Besides, burn accidents in age group 0-3 were self-induced out of ignorance, whereas children aged 6-12 were most likely to be burned due to unintentional ignorance by others. Finally, burn area and burn types were the two significant predictors of length of hospital stay, together accounting for 70.8% of the variance. Our results were valuable in that the professionals working with the burned children, the parents or the primary caregivers can better understand the risk factors in relation to burns, and implement programs to prevent burn injury.

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