调查北京市某区三甲医院创面修复专科皮肤软组织损伤住院病例，探讨其流行病学特征以及相关诊疗信息。

回顾性分析解放军总医院第四医学中心烧伤整形暨创面修复中心2017年1月1日至12月31日收治的全部住院患者资料。统计患者基本信息，创面的类型、部位与创面微生物培养结果，治疗方式和结果，以及卫生经济学信息。描述住院患者流行病学特征，分别比较性别、病程、类型、治疗方式因素对创面细菌感染、疗效、住院时间及住院费用的影响。数据行单因素方差分析、Wilcoxon秩和检验、Kruskal-Wallis H检验、χ²检验与H检验。

最终纳入研究639例患者，男420例，女219例。(1)患者平均年龄为57.00(43.00～67.00)岁，女性患者平均年龄大于男性患者，差异有统计学意义(Z＝－2.605, P<0.05)；(2)290例患者合并有慢性基础性疾病，最常见的疾病依次为糖尿病、高血压、冠状动脉粥样硬化性心脏病；(3)慢性皮肤软组织损伤患者数量多于急性皮肤软组织损伤患者；(4)最常见的创面类型依次为术后难愈性伤口、糖尿病足部溃疡、压力性损伤与皮肤软组织感染，最常见的创面部位依次为足部、下肢及胸部；(5)创面细菌学检查显示革兰氏阴性菌构成比最高(57.61%)，常见细菌依次为金黄色葡萄球菌、大肠杆菌、肺炎克雷伯氏菌、奇异变形杆菌、铜绿假单胞菌；(6)136例患者行单纯换药治疗，118例行单纯持续负压封闭引流治疗，385例行手术治疗，其中130例行多次手术治疗。治愈282例，好转313例，未愈39例，死亡5例；(7)人均花费34 354.15(16 449.72～75 018.24)元；人均住院时间21.00(11.00～40.00) d。按创面类型分类，免疫疾病性皮肤溃疡患者的住院费用和时间最高，肥厚性瘢痕患者的住院费用和时间最低。按费用类型划分，工伤保险患者的住院费用和时间最高，自费医疗患者的住院费用和时间最低。

患者多为中老年，多合并慢性基础性疾病；病程主要以慢性皮肤软组织损伤为主，常见创面类型为术后难愈性伤口、糖尿病足部溃疡、压力性损伤及皮肤软组织感染，创面部位集中于下肢、足部及胸部；革兰氏阴性菌感染的比例较高，需要加强对此类病菌的抗生素治疗；外科清创术、负压封闭引流技术是治疗皮肤软组织损伤患者的有效措施。

To retrospectively investigate the epidemiological characteristics and related medical information of hospitalized cases of skin and soft tissue injury in wound repair center from a tertiary hospital in Beijing.

All data of hospitalized cases from January 1, 2017 to December 31 in the Department of Burns and Plastic Surgery, Wound Repair Center, Fourth Medical Center of Chinese PLA General Hospital were collected and analyzed. The information included patients basic data, wound types, locations and microbiology information, therapies, outcomes, and health economics information. The epidemiological features of hospitalized patients was described, and the effects of gender, course of wound, wound type, treatment on wound infection, curative effects, hospitalization time and hospitalization expenses were compared. Data were processed with one-way analysis of variance, Wilcoxon rank test, Kruskal-Wallis H test, chi-square test and H test.

Six hundred and thirty-nine patients were finally included in this study, including 420 males and 219 females. (1) The mean age of patients was 57.00 (43.00-67.00) years old, the mean age of female was greater than that of male, the difference was statistically significant (Z=-2.605, P<0, 05). (2) Two hundred and ninty patients with chronic basic diseases, the most common diseases were diabetes mellitus, hypertension, coronary atherosclerotic heart disease. (3) The number of patients with chronic skin and soft tissue injuries was more than acute skin and soft tissue injuries. (4) The most common causes were postoperative non-healing wounds, diabetic foot ulcer, pressure injury and soft tissue infections, the most common locations were the feet, lower extremities and chests. (5) Bacterial examination of the wound showed Gram-negative bacteria composition ratio was the highest (57.61%). Common bacteria were Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa. (6) One hundred and thirty-six patients underwent simple dressing treatment, 118 underwent simple continuous negative pressure drainage, and 385 underwent surgical treatment, of which 130 underwent multiple surgical treatments. Two hundred and eighty-two patients were cured, 313 improved, 39 not healed, and 5 people dead. (7) The average hospitalization expense was 34, 354.15 (16 449.72-75 018.24) yuan. The average length of hospital stay was 21.00 (11.00-40.00) days. According to the wound types, the hospitalization expense and day of immune-mediated skin ulcer were the highest, and the hospitalization expense and day of hypertrophic scar were the lowest. According to the cost types, the hospitalization expense and day of patients with employment injury insurance are the highest, and the hospitalization expense and day of self-paying patients were the lowest.

Most of the patients are middle-aged and older, and with chronic basic diseases. The main course of the disease is chronic skin and soft tissue injury. The common causes are postoperative non-healing wounds, diabetic foot ulcer, pressure injuries and soft tissue infections. The sites are concentrated in the feet, lower limbs and chests. The proportion of Gram-negative bacteria infection is higher, which showes that it is necessary to strengthen the antibiotic treatment of such microbiology. Surgical debridement, continuous negative pressure drainage are effective measures for the treatment of patients with skin and soft tissue injury.