Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns
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Zhonghua Shao Shang Za Zhi · Feb 2019
Comparative Study[Characteristics of patients with tuberculous wounds and non-tuberculous chronic refractory wounds in single center].
Objective: To explore the characteristics of patients with tuberculous wounds and non-tuberculous chronic refractory wounds in single center. Methods: From January 2010 to June 2017, 43 patients with tuberculous wounds and 44 patients with non-tuberculous chronic refractory wounds admitted to the Department of Burns and Plastic Surgery of the Eighth Medical Center of the General Hospital of the Chinese People's Liberation Army were conforming to the inclusion criteria. The patients were assigned to tuberculous wound group and non-tuberculous wound group, respectively, and their clinical records were retrospectively analyzed. ⋯ There was no statistically significant difference in the composition ratio of sources of medical expense between patients in the two groups (χ(2)=1.154, P>0.05). (6) There were statistically significant differences in expenses for diagnosis, medicine, surgery, examination, laboratory test, and bed, and total expenses paid by social basic medical insurance and the self-payment between patients in tuberculous wound group and non-tuberculous wound group (t=45.051, 39.995, 64.212, 32.584, 8.754, 43.991, 15.671, 17.640, 65.155, 35.546, 35.903, -4.329, 3.344, 12.984, P<0.01). Conclusions: Compared with those of patients with non-tuberculous chronic refractory wounds, the tuberculous wounds of patients have longer formation time, the diagnosis and treatment of the wounds are difficult, their wounds are mostly distributed in the chest and often accompanied by sinus formation, and patients with the wounds have long hospital stay and high medical expenses. Besides, the medical expenses for treating wounds of patients in the two groups are mainly paid by social basic medical insurance and the patients themselves.
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Zhonghua Shao Shang Za Zhi · Feb 2019
[Analysis of causes and treatment methods of complication of early acute kidney injury in four severely burned patients].
Objective: To analyze the causes of complication of early acute kidney injury (AKI) in four severely burned patients, and to explore the related treatment methods. Methods: The clinical data of 4 patients with severe burn complicated with early AKI admitted to Guangzhou Red Cross Hospital Affiliated to Medical College of Jinan University (hereinafter referred to as our hospital) from June 2014 to December 2017 were retrospectively analyzed. All the patients were male, aged 23-33 (30±5) years old, with depth of burns ranged from deep partial-thickness to full-thickness, complicated with myofascial compartment syndrome of extremities and varying degrees of striated muscle injury, and treated in other hospitals before transfer to our hospital. ⋯ Follow-up for 1 to 36 months showed no abnormal renal function in 4 patients. Conclusions: The early AKI in patients No. 1 and 4 was caused by rhabdomyolysis after severe burn complicated with myofascial compartment syndrome, while that of the other 2 cases were also related to hypovolemic shock and poor renal perfusion. The success rate of early AKI treatment in severely burned patients can be effectively improved by removing the causes of diseases at the same time of CRRT and actively treating burn wounds under the support of organ function and hemodynamic monitoring.