59例平原地区冻伤情况分析

Analysis of 59 cases of frostbite in plain region

目的回顾性调查平原地区患者冻伤情况，分析该地区冻伤特点及就医结果。方法1992--2007年，北京积水潭医院收治冻伤住院患者59例，年龄15～85岁。统计患者职业、致伤原因、初次就诊时间、冻伤部位及损伤程度（以烧伤深度为判定标准）和致残率。结果59例患者职业以工人和无业人员居多，主要致伤原因依次为户外活动、意识障碍、接触低温物质，初次就诊时间平均在伤后11d。浅Ⅱ～深Ⅱ度冻伤12例、Ⅲ～Ⅳ度冻伤47例，共40例截肢或截指。受伤3d内（含第3天）就诊患者冻伤程度、致残率与受伤3d后就诊患者比较，差异有统计学意义（P〈0．05）；不同部位冻伤致残率比较，差异无统计学意义（P〉0．05）。结论平原地区冻伤患者以四肢末端为主，伤后早期就诊可以减轻冻伤程度并降低致残率。

Objective To retrospectively survey frostbite in patients tiving in plain regions, and to analyze the features of frostbite and the results after hospitalization. Methods Fifty-nine patients with frostbite, aged from 15 to 85 years admitted in Beijing Jishuitan Hospital from 1992 to 2007, were enrolled in this study. Occupation, cause of the injury, initial visit time, position and degree of depth （assessed according to the standard of burn injury） of frostbite, and amputation rate of patients were recorded and analyzed. Results Most patients of the 59 cases were workers or unemployed, the main reasons of injury were prolonged contact with material in a low temperature, with impaired consciousness, and having an outdoor activity. The average first visit time was 11 days after the exposure. Frostbite was superficial 2^rd to deep 2^nd degree in 12 patients, while 47 patients were found to have 3^rd to 4^th degree injury. Limbs, or fingers and toes were amputated from 40 patients. The differences between patients visited within 3 days after frostbite and patients visited later than 3 days in respect of degree of depth of frostbite and amputation rate were statistically significant （ P 〈 0.05 ）. There was no significant difference in amputation rates in different body parts of frostbite （ P 〉 0.05）. Conclusions Patients in plain regions mainly suffer frostbite at the distal portions of the extremities. They should visit hospital early after injury so that the degree of frostbite can be alleviated and rate of amputation can be lowered.