Clinical Analysis Of Renal Function In 43 Adult Patients With Massive Burn Injury

Objective:To explore the related influencing factors of acute kidney injury in massive burn injury,and to provide a clinical reference for improving the cure rate of massive burn injury.Methods:43 cases of massive burn injury in adult were divided into Normal renal function group and Acute kidney injury group.Cases come from patients admitted to our department from November 2012 to April 2018.Statistical analysis was performed on the Age,Total burn area,?°burn area,Recovery time,Shock period transition,Severity of inhalation injury,Early Blood glucose,Systemic infection,etc.Results:In 43 patients with massive burn injury:1.The age group of 31-40 years old is the largest,with 15 cases,accounting for 34.88%,the mean age of normal renal function group was 40.92±9.47years.The mean age of patients in the normal renal function group was 40.92±9.47years old,and the mean age of patients in the renal function injury group was 40.60±14.87 years old.There was no significant difference in the mean age between the two groups(t=-0.08P=0.930).2.There were 34 males and 9 females,and the ratio of male to female was 3.8:1.3.The number of patients with flame burns was 39,accounting for90.69%,which was the most common cause of injury.4.The number of patients with 80%to 90%TBSA reached 33 cases,including 9 cases in the renal function injury group.The number of patients with 91%to 100%TBSA reached 10 cases,including 6 cases in the renal function injury group.5.The mean total burn area of the normal renal function group(85.71±5.10)%TBSA,and the mean total burn area of the renal function injury group(90.53±5.91)%TBSA,the difference of total burn area between the two groups was statistically significant(t=2.79 P=0.008).Normal renal function group average?°burn area was 27.39±25.39%TBSA,renal injury group average?°burn area was 48.13±27.16%TBSA.Two groups of patients in?°burn area differences compared with statistical significance(t=2.49,P=0.017).6.Among the 43 patients with massive burn injury,there were 28 cases in the group with normal renal function,among which 6 cases had no or slight inhalation injury and 22 cases had moderate or severe inhalation injury.There were 15 cases of renal function injury in the group,all of which were moderate to severe inhalation injury.There was no statistically significant difference in severity of inhalation injury and renal function between the two groups(?~2=3.73 P=0.053).7.In the resuscitation group over 6 hours,there were 5 patients with renal injury.However,among the38 patients who were resuscitated within 6h,10 patients were in the kidney function injury group,and the difference between the two groups was statistically significant(t=2.57p=0.020).8.Among the 43 cases with massive burn injury,25 cases had unstable transition during the shock period,among which 14 cases had renal injury.There were 18 cases of smooth transition during the shock period,and 1 case of renal injury.There was no statistically significant difference in Shock period transition and renal function between the two groups(?~2=11.72 P=0.001).9.The mean early blood glucose change in the normal renal function group was 11.62±3.78mmol/L,and the mean early blood glucose change in the renal function injury group was 14.94±5.80mmol/L,and the difference between the two groups was statistically significant(t=2.26 p=0.029).10.There were 24 cases of severe burns complicated by burn sepsis,including 12 cases of renal function injury.However,3 of the 19 patients without sepsis had renal function injury,and the difference between the two groups was statistically significant(?~2=5.46 P=0.019).11.Through Cox regression analysis of the above factors with statistical significance,the results showed that post-injury resuscitation time and the total area of burns were the main risk factors.Conclusion:1.The post-injury resuscitation time and the total area of burns were the main risk factors in this group.2.The incidence of acute renal function injury in adults with massive burn injury were positively correlated with the total area of burns,?° burn area,recovery time after injury,unstable transition during the shock period,early blood glucose change,burn sepsis in this group.3.The incidence of renal function injury in adults with massive burn injury was not correlated with the age and severity of inhalation injury of the patients in this group.