Evaluation des perturbations biologiques chez les brulés admis aux urgences
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Abstract
Objectif-
Les brûlures endommagent la peau et les tissus, et peuvent entraîner selon le degré de la brûlure et la surface du corps brûlé des défaillances d’organes à l’origine de plusieurs perturbations biologiques. L’objectif de la présente étude est l’évaluation des perturbations biologiques chez une cohorte de brûlés adultes et enfants admis au niveau des urgences de l’établissement hospitalier spécialisés des brûlés d’Oran (Algérie).
Matériels et Méthodes-Il s’agit d’une étude rétrospective s’étalant du mois d’octobre 2023 au mois d’avril 2024. Les données cliniques analysées sont : l’âge, le sexe et la surface du corps brûlé. Les variables biologiques prises en considération sont : la glycémie, l’albumine, les transaminases, la CRP, l’ionogramme sanguin et la numération de formule sanguine. Les données ont été analysées avec le logiciel SPSS version 20.
Résultats-
539 patients ont été inclus dans notre étude dont 213 (40 %) adultes âgés de 18 à 92 ans et 326 (60%) enfants âgés de 12 mois à 17 ans. Nos résultats ont révélé que les principales anomalies biologiques observées respectivement chez les adultes et enfants sont les suivantes : hyperglycémie, (47%, 55%) hypoalbuminémie (22%, 27%), élévation des transaminases ASAT (47%, 4%), ALAT (45%, 88%), hyponatrémie (32%, 38%), hyperkaliémie (3%, 18%), hypokaliémie (23%, 22%), CRP (33% des enfants), hyperleucocytose (71%, 73%), Anémie (18%, 38%) et thrombocytose (38%,71%). Une corrélation significative a été retrouvée dans la série adulte entre la surface du corps brûlé supérieure à 10% et l’hyperleucocytose.
Conclusion
- l’évaluation biologique à l’admission aux urgences est nécessaire pour déceler les dommages et orienter le traitement. L’étude des biomarqueurs prédictifs est également importante pour pouvoir prédire le pronostic de la brûlure afin d’optimiser la prise en charge des patients brûlés
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