Analysis Of Related Factors Of Normal Serum Creatinine And Elevated Blood Urea Nitrogen In Severely Burned Patients

Objective:Retrospective analysis was conducted to investigate the incidence and clinical characteristics of blood urea nitrogen in patients with severe burns when serum creatinine was normal,and to explore the related factors leading to elevated blood urea nitrogen.Method:1.Choose to collect burn patients who came to our department from July 2013 to August 2018.According to the inclusion criteria and exclusion criteria,there were330 burn patients enrolled in the study range,and 149 patients with elevated blood urea nitrogen as liters.In the high group,181 patients with normal blood urea nitrogen were used as the normal group.According to the literature reports and clinical treatment data,the case data of the two groups were collected including gender,age,burn area,burn index;amino acid type,dose and amino acid initial input time;blood urea nitrogen increase start time,duration;wound healing Time and morning blood white blood cells,total protein,albumin,aspartate aminotransferase,creatinine,urea nitrogen,glucose and other test indicators.2.Differences in gender,age,burn index,wound healing time,etc.between the elevated and normal groups.3.According to the burn area,the patients in the elevated group were divided into two areas: 31-50% TBSA and 51-80% TBSA.The relationship between the incidence of blood urea nitrogen elevation,the onset time and duration and the total burn area were analyzed.4.Select gender,age,burn index,amino acid type,amino acid dose,amino acid start input time and 12 possible factors related to white blood cells,total protein,albumin,aspartate aminotransferase,creatinine,glucose,etc.Univariate analysis was performed first,followed by statistically significant factors for Logistic multivariate analysis.Result:1.A total of 330 patients were included in the study.A total of 149 patients in the elevated group,accounting for 45.15% of the total number of cases,110 males and 39 females,the male to female ratio was 2.82:1;the average age(42.86 ± 11.08)years;blood urea nitrogen average(10.24± 1.20)mmol/L;burn index The average(51.40±15.69);wound healing time averaged(57.82±11.30)days.A total of 181 patients in the normal group,accounting for 54.85% of the total number of cases,136 males and 45 females,male to female ratio of 3.02:1;average age(41.56 ± 8.16)years;blood urea nitrogen average(5.07±1.30)mmol/L;burn index average(51.40 ±15.69);wounds The healing time averaged(52.10 ± 13.84)days.There were no significant differences in gender and age between the two groups(P>0.05).There were significant differences in burn index and wound healing time between the two groups(P<0.05).2.In the elevated group,the increase in blood urea nitrogen in the 31-50% TBSA area accounted for 38.24% of the total number of people in the area,and the initial time of blood urea nitrogen elevation was(9.35±4.74)days after admission.The duration was(12.5±5.18)days;the increase of blood urea nitrogen in the area of51-80% TBSA accounted for 56.35% of the total number of people in the area,and the starting time of blood urea nitrogen elevation was(6.36±3.45)days.The duration was(17.31±6.00)days;the incidence of blood urea nitrogen elevation,start time,duration and total burn area were statistically significant(P<0.05).3.Univariate analysis: in this data,the analysis showed that white blood cells,burn index,amino acid start input time and other three factors were associated with elevated blood urea nitrogen,the difference was statistically significant(P<0.05);Nine factors including age,total protein,albumin,creatinine,glucose,amino acid type,and amino acid dose were not associated with elevated blood urea nitrogen,and the difference was not statistically significant(P>0.05).4.Multivariate regression analysis: statistically significant factors in univariate analysis were used as independent variables,and urea nitrogen was used as a dependent variable to be included in the logistic regression model for analysis(stepwise analysis).The results showed that: burn index(OR>1,P< 0.05),whiteblood cells(OR>1,P<0.05),amino acid initial input time(OR>1,P<0.05)were independent risk factors for blood urea nitrogen elevation.Conclusion:1.In patients with severe burns,the proportion of blood urea nitrogen increased when blood creatinine is normal,the higher the incidence of blood urea nitrogen elevation,the higher the starting time Early,the longer the duration.2.The continuous increase of blood urea nitrogen may prolong the wound healing time.3.The severity of burns,the infection status,and the initial input time of amino acids are independent risk factors for the increase of blood urea nitrogen in patients with severe burns when serum creatinine is normal.