Objective: To validate the clinical effect of three dimensional human body scanning system BurnCalc developed by our research team in the evaluation of burn wound area. Methods: A total of 48 burn patients treated in the outpatient department of our unit from January to June 2015, conforming to the study criteria, were enrolled in. For the first 12 patients, one wound on the limbs or torso was selected from each patient. The stability of the system was tested by 3 attending physicians using three dimensional human body scanning system BurnCalc to measure the area of wounds individually. For the following 36 patients, one wound was selected from each patient, including 12 wounds on limbs, front torso, and side torso, respectively. The area of wounds was measured by the same attending physician using transparency tracing method, National Institutes of Health (NIH) Image J method, and three dimensional human body scanning system BurnCalc, respectively. The time for getting information of 36 wounds by three methods was recorded by stopwatch. The stability among the testers was evaluated by the intra-class correlation coefficient (ICC). Data were processed with randomized blocks analysis of variance and Bonferroni test. Results: (1) Wound area of patients measured by three physicians using three dimensional human body scanning system BurnCalc was (122±95), (121±95), and (123±96) cm(2,) respectively, and there was no statistically significant difference among them ( F=1.55, P>0.05). The ICC among 3 physicians was 0.999. (2) The wound area of limbs of patients measured by transparency tracing method, NIH Image J method, and three dimensional human body scanning system BurnCalc was (84±50), (76±46), and (84±49) cm(2,) respectively. There was no statistically significant difference in the wound area of limbs of patients measured by transparency tracing method and three dimensional human body scanning system BurnCalc (P>0.05). The wound area of limbs of patients measured by NIH Image J method was smaller than that measured by transparency tracing method and three dimensional human body scanning system BurnCalc (with P values below 0.05). There was no statistically significant difference in the wound area of front torso of patients measured by transparency tracing method, NIH Image J method, and three dimensional human body scanning system BurnCalc (F=0.33, P>0.05). The wound area of side torso of patients measured by transparency tracing method, NIH Image J method, and three dimensional human body scanning system BurnCalc was (169±88), (150±80), and (169±86) cm(2,) respectively. There was no statistically significant difference in the wound area of side torso of patients measured by transparency tracing method and three dimensional human body scanning system BurnCalc (P>0.05). The wound area of side torso of patients measured by NIH Image J method was smaller than that measured by transparency tracing method and three dimensional human body scanning system BurnCalc (with P values below 0.05). (3) The time for getting information of wounds of patients by transparency tracing method, NIH Image J method, and three dimensional human body scanning system BurnCalc was (77±14), (10±3), and (9±3) s, respectively. The time for getting information of wounds of patients by transparency tracing method was longer than that by NIH Image J method and three dimensional human body scanning system BurnCalc (with P values below 0.05). The time for getting information of wounds of patients by three dimensional human body scanning system BurnCalc was close to that by NIH Image J method (P>0.05). Conclusions: The three dimensional human body scanning system BurnCalc is stable and can accurately evaluate the wound area on limbs and torso of burn patients.
目的： 验证本课题组研发的BurnCalc人体三维扫描系统在烧伤创面面积评估中的临床应用效果。 方法： 2015年1—6月，笔者单位门诊共就诊符合入选标准的48例烧伤患者。对先就诊的12例患者，每例患者选取1个位于四肢或者躯干部位的创面，由3名主治医师分别使用BurnCalc人体三维扫描系统单独测量创面面积，进行系统稳定性测试。对后就诊的36例患者，每例患者选取1个创面，其中四肢、前躯干、侧躯干创面各12个，由同一名主治医师分别采用无菌薄膜勾边法、美国国立卫生研究院(NIH) Image J法、BurnCalc人体三维扫描系统测量创面面积。使用秒表记录3种测量方法分别获取36个创面信息所用时间。使用组内相关系数(ICC)评价测试者之间的稳定性，对数据行随机区组方差分析和Bonferroni检验。 结果： (1)3名医师使用BurnCalc人体三维扫描系统测量所得患者创面面积分别为(122±95)、(121±95)、(123±96)cm(2)，总体比较，差异无统计学意义(F＝1.55，P>0.05)。3名医师之间的ICC为0.999。(2)无菌薄膜勾边法、NIH Image J法、BurnCalc人体三维扫描系统测量所得患者四肢创面面积分别为(84±50)、(76±46)、(84±49)cm(2)，无菌薄膜勾边法与BurnCalc人体三维扫描系统测量所得患者四肢创面面积比较，差异无统计学意义(P>0.05)；NIH Image J法测量所得患者四肢创面面积小于无菌薄膜勾边法及BurnCalc人体三维扫描系统(P值均小于0.05)。无菌薄膜勾边法、NIH Image J法、BurnCalc人体三维扫描系统测量所得患者前躯干创面面积总体比较，差异无统计学意义(F＝0.33，P>0.05)。无菌薄膜勾边法、NIH Image J法、BurnCalc人体三维扫描系统测量所得患者侧躯干创面面积分别为(169±88)、(150±80)、(169±86)cm(2)，无菌薄膜勾边法与BurnCalc人体三维扫描系统测量所得患者侧躯干创面面积比较，差异无统计学意义(P>0.05)；NIH Image J法测量所得患者侧躯干创面面积小于无菌薄膜勾边法及BurnCalc人体三维扫描系统(P值均小于0.05)。(3)无菌薄膜勾边法、NIH Image J法、BurnCalc人体三维扫描系统获取患者创面信息所用时间分别为(77±14)、(10±3)、(9±3)s，无菌薄膜勾边法获取患者创面信息所用时间长于NIH Image J法及BurnCalc人体三维扫描系统(P值均小于0.05)，BurnCalc人体三维扫描系统获取患者创面信息所用时间与NIH Image J法相近(P>0.05)。 结论： BurnCalc人体三维扫描系统操作稳定，可以准确评估烧伤患者四肢和躯干创面面积。.
Keywords: Body surface area; Burns; Extremities; Imaging, three-dimensional; National Institutes of Health (NIH) Image J method; Transparency tracing method; Trunk.