Objective: To explore the influence of three-level collaboration network of pediatric burns in Anhui province on treatment effects of burn children. Methods: The data of medical records of pediatric burn children transferred from Lu'an People's Hospital and Fuyang People's Hospital to the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2015 and January 2016 to September 2017 (before and after establishing three-level collaboration network of pediatric burns treatment) were analyzed: percentage of transferred burn children to hospitalized burn children in corresponding period, gender, age, burn degree, treatment method, treatment result, occurrence and treatment result of shock, and operative and non-operative treatment time and cost. Rehabilitation result of burn children transferred back to local hospitals in 2016 and 2017. Data were processed with t test, chi-square test, Mann-Whitney U test, and Fisher's exact test. Results: (1) Percentage of burn children transferred from January 2014 to December 2015 was 34.3% (291/848) of the total number of hospitalized burn children in the same period of time, which was close to 30.4% (210/691) of burn children transferred from January 2016 to September 2017 (χ(2)=2.672, P>0.05). (2) Gender, age, burn degree, and treatment method of burn children transferred from the two periods of time were close (χ(2)=3.382, Z=-1.917, -1.911, χ(2)=3.133, P>0.05). (3) Cure rates of children with mild, moderate, and severe burns transferred from January 2016 to September 2017 were significantly higher than those of burn children transferred from January 2014 to December 2015 (χ(2)=11.777, 6.948, 4.310, P<0.05). Cure rates of children with extremely severe burns transferred from the two periods of time were close (χ(2)=1.181, P>0.05). (4) Children with mild and moderate burns transferred from the two periods of time were with no shock. The incidence of shock of children with severe burns transferred from January 2014 to December 2015 was 6.0% (4/67), and 3 children among them were cured. The incidence of shock of children with severe burns transferred from January 2016 to September 2017 was 3.9% (2/51), and both children were cured. The incidences and cures of shock of children with severe burns transferred from the two periods of time were close (χ(2)=0.006, P>0.05). Incidence of shock of children with extremely severe burns transferred from January 2014 to December 2015 was 57.1% (32/56), significantly higher than that of burn children transferred from January 2016 to September 2017 [34.5% (10/29), χ(2)=3.925, P<0.05]. Shock of 25 children with extremely severe burns transferred from January 2014 to December 2015 were cured, and shock of 9 children with extremely severe burns transferred from January 2016 to September 2017 were cured. The cures of shock of children with extremely severe burns transferred from the two periods of time were close ( χ(2)=0.139, P>0.05). (5) Time of operative treatment of children with moderate, severe, and extremely severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 (t=2.335, 2.065, 2.310, P<0.05). Time of operative treatment of children with mild burns transferred from the two periods of time was close (Z=-0.417, P>0.05). Costs of operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were significantly more than those of burn children transferred from January 2016 to September 2017 (Z=-3.324, t=2.167, P<0.05). Costs of operative treatment of children with mild and extremely severe burns transferred from the two periods of time were close (t=0.627, 0.808, P>0.05). (6)Time of non-operative treatment of children with mild, moderate, and severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 (t=2.335, Z=-2.095, t=2.152, P<0.05). Time of non-operative treatment of children with extremely severe burns transferred from the two periods of time was close (t=0.450, P>0.05). Costs of non-operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were obviously higher than those of burn children transferred from January 2016 to September 2017 (Z=-2.164, t=2.040, P<0.05). Costs of non-operative treatment of children with mild and extremely severe burns transferred from the two periods of time were close (t=0.146, 1.235, P>0.05). (7) Sixty-seven burn children transferred from January 2016 to September 2017 were transferred back to local hospitals for rehabilitation under the guidance of experts of the First Affiliated Hospital of Anhui Medical University, with 25 patients in 2016 and 42 patients in 2017. Effective rehabilitation rates of burn children transferred back to local hospitals for rehabilitation in 2016 and 2017 were both 100%. Conclusions: The three-level collaboration network of pediatric burns treatment in Anhui province can effectively increase cure rate of children with mild, moderate, and severe burns, reduce incidence of shock of children with extremely severe burns, shorten time of operative treatment of burn children with moderate, severe, and extremely severe burns, and time of non-operative treatment of children with mild, moderate, and severe burns, reduce treatment costs of children with moderate and severe burns, and improve rehabilitation effectiveness of children transferred from Lu'an People's Hospital and Fuyang People's Hospital to the the First Affiliated Hospital of Anhui Medical University.
目的： 了解安徽省小儿烧伤治疗三级协作网对烧伤患儿治疗效果的影响。 方法： 统计2014年1月—2015年12月，即建立小儿烧伤治疗三级协作网前，以及2016年1月—2017年9月，即建立小儿烧伤治疗三级协作网后，六安市人民医院和阜阳市人民医院转入安徽医科大学第一附属医院的烧伤患儿占同期住院烧伤患儿的比例、性别、年龄、烧伤严重程度、治疗方式、治疗结局、休克发生情况及其治疗结局、手术和非手术治疗时间和费用，2016、2017年转回当地医院烧伤患儿康复治疗结局。对数据行t检验、χ(2)检验、Mann－Whitney U检验及Fisher确切概率法检验。 结果： (1)2014年1月—2015年12月转入烧伤患儿占同期住院烧伤患儿总数的34.3%(291/848)，与2016年1月—2017年9月的30.4%(210/691)相近(χ(2)＝2.672，P>0.05)。(2)2个时间段转入烧伤患儿性别、年龄、烧伤严重程度、治疗方式相近(χ(2)＝3.382，Z＝－1.917、－1.911，χ(2)＝3.133，P>0.05)。(3)2016年1月—2017年9月转入轻度、中度、重度烧伤患儿治愈率明显高于2014年1月—2015年12月(χ(2)＝11.777、6.948、4.310，P<0.05)。2个时间段转入特重度烧伤患儿治愈率相近(χ(2)＝1.181，P>0.05)。(4)2个时间段转入轻度、中度烧伤患儿均未发生休克。2014年1月—2015年12月转入重度烧伤患儿休克发生率为6.0%(4/67)，其中3例治愈；2016年1月—2017年9月转入重度烧伤患儿休克发生率为3.9%(2/51)，2例均治愈；2个时间段转入重度烧伤患儿休克发生率和治愈情况相近(χ(2)＝0.006，P>0.05)。2014年1月—2015年12月，转入特重度烧伤患儿休克发生率为57.1%(32/56)，明显高于2016年1月—2017年9月的34.5%(10/29)，χ(2)＝3.925，P<0.05；2014年1月—2015年12月转入发生休克的特重度烧伤患儿中25例治愈，2016年1月—2017年9月转入发生休克的特重度烧伤患儿中9例治愈，2个时间段转入特重度烧伤患儿治愈情况相近(χ(2)＝0.139，P>0.05)。(5)2014年1月—2015年12月转入中度、重度、特重度烧伤患儿手术治疗时间明显长于2016年1月—2017年9月(t＝2.335、2.065、2.310，P<0.05)，2个时间段转入轻度烧伤患儿手术治疗时间相近(Z＝－0.417，P>0.05)。2014年1月—2015年12月转入中度、重度烧伤患儿手术治疗费用明显高于2016年1月—2017年9月(Z＝－3.324，t＝2.167，P<0.05)，2个时间段转入轻度、特重度烧伤患儿手术治疗费用相近(t＝0.627、0.808，P>0.05)。(6)2014年1月—2015年12月转入轻度、中度、重度烧伤患儿非手术治疗时间明显长于2016年1月—2017年9月(t＝2.335，Z＝－2.095，t＝2.152，P<0.05)。2个时间段转入特重度烧伤患儿非手术治疗时间相近(t＝0.450，P>0.05)。2014年1月—2015年12月转入中度、重度烧伤患儿非手术治疗费用明显高于2016年1月—2017年9月(Z＝－2.164，t＝2.040，P<0.05)。2个时间段转入轻度、特重度烧伤患儿非手术治疗费用相近(t＝0.146、1.235，P>0.05)。(7)2016年1月—2017年9月，67例烧伤患儿转回当地医院在安徽医科大学第一附属医院专家指导下进行康复治疗，其中2016年25例、2017年42例。2016、2017年转回当地医院进行康复治疗烧伤患儿康复有效率均为100%。 结论： 安徽省小儿烧伤治疗三级协作网可有效提高六安市人民医院和阜阳市人民医院转入安徽医科大学第一附属医院轻度、中度、重度烧伤患儿治愈率，降低特重度烧伤患儿休克发生率，缩短中度、重度、特重度烧伤患儿手术治疗时间和轻度、中度、重度烧伤患儿非手术治疗时间，减少中度、重度烧伤患儿治疗费用，提到康复有效率。.
Keywords: Burns; Child; Three-level collaboration network of pediatric burns.