不同烧伤面积患者早期钙离子浓度的影响因素与临床意义

Influencing factors and clinical significance of early calcium concentration in patients with different burn areas

摘要:

目的 分析不同烧伤面积患者早期钙离子浓度的影响因素与临床意义。方法 选取2019年1月—2022年6月南通大学附属医院烧伤整形外科收治的符合入选标准的住院患者116例作为研究对象，对其病例资料进行回顾性分析。结果 两组患者的性别、年龄、吸入性损伤及入院时间比较，差异均无统计学意义（P >0.05）。发生低钙血症患者三度创面的比例高于未发生低钙血症患者，发生低钙血症患者入院时白蛋白浓度低于未发生低钙血症患者，烧伤面积大于未发生低钙血症患者（P <0.05）。患者三度创面、大面积烧伤（烧伤面积> 50%）、低蛋白血症等因素间钙离子浓度比较，差异均有统计学意义（P <0.05）；患者性别、年龄、吸入性损伤、延迟复苏（入院时间 > 6 h）等因素间钙离子浓度比较，差异均无统计学意义（P >0.05）。多因素逐步线性回归分析结果显示，大面积烧伤、低蛋白血症及年龄是影响患者入院时钙离子浓度的独立危险因素（P <0.05），且大面积烧伤与低蛋白血症是影响钙离子浓度的主要因素。患者三度创面、大面积烧伤、低蛋白血症、低钙血症等因素间创面愈合时间比较，差异均有统计学意义（P <0.05）；患者性别、年龄、吸入性损伤、延迟复苏等因素间创面愈合时间比较，差异均无统计学意义（P >0.05）。多因素逐步线性回归分析结果显示，大面积烧伤、三度创面及年龄是影响患者创面愈合时间的独立危险因素。（P <0.05），且烧伤总面积是影响患者创面愈合时间的最主要因素，三度创面次之。结论 大部分烧伤患者入院后会发生低钙血症，有三度创面、白蛋白浓度低、烧伤总面积大的患者发生低钙血症的可能性更大。有三度创面、大面积烧伤、年龄大的患者创面愈合时间明显延长，钙离子浓度不是患者创面愈合时间的独立危险因素。

Abstract:

Objective To analyze the influencing factors and clinical significance of early calcium ion concentration in patients with different burn areas.Methods A total of 116 inpatients meeting the inclusion criteria were selected from the Department of Burns and Plastic Surgery of the Affiliated Hospital of Nantong University from January 2019 to June 2022. A retrospective analysis of their medical records was conducted.Results There were no statistically significant differences in gender composition, age, inhalation injury, and admission time between the two groups (P > 0.05). The proportion of patients with third-degree burns who developed hypocalcemia was higher than that of patients without hypocalcemia. Patients with hypocalcemia had lower albumin concentrations and larger burn areas at admission compared to those without hypocalcemia (P < 0.05). The calcium ion concentrations were significantly different among patients with third-degree burns, those with large burn areas (burn area > 50%), and those with hypoproteinemia (P < 0.05). However, there were no significant differences in calcium ion concentrations based on gender, age group, inhalation injury, or delayed resuscitation (admission time > 6 h) (P > 0.05). Multivariate stepwise linear regression analysis showed that the total burn area, albumin concentration at admission, and age were independent risk factors for calcium ion concentration at admission (P < 0.05), with the total burn area and albumin concentration at admission being the main factors affecting calcium ion concentration. The healing time of wounds was significantly different among patients with third-degree burns, those with large burn areas, those with hypoproteinemia, and those with hypocalcemia (P < 0.05). However, there were no significant differences in wound healing time based on gender, age group, inhalation injury, or delayed resuscitation (P > 0.05). Multivariate stepwise linear regression analysis showed that the total burn area, the presence of third-degree burns, and age were independent risk factors for wound healing time (P < 0.05), with the total burn area being the most significant factor affecting wound healing time, followed by third-degree burns.Conclusion Most burn patients develop hypocalcemia after admission, and patients with third-degree burns, low albumin concentrations, and large burn areas are more likely to develop hypocalcemia. Older age, third-degree burns, and large burn areas are associated with significantly prolonged wound healing time, but calcium ion concentration is not an independent risk factor for wound healing time.