儿童手指损伤512例临床分析

Clinical analysis of 512 cases of children's finger injuries.

目的了解我院诊治的儿童手指损伤的流行病学特征,为其预防和治疗提供科学依据。方法回顾性分析2013年1月至2018年1月在滨州医学院附属医院就诊的512例手指损伤儿童患者的临床资料及随访情况,应用χ2检验比较不同分组各指标的关系。结果①致伤因素:512例患者中最常见的致伤因素是门(车)窗挤压伤,但随着年龄增长,裂伤和运动伤逐渐增多。②损伤类型:中指损伤在学龄前组最常见(33.98%),且与其他手指损伤相比差异有统计学意义(P<0.05);而拇指损伤在学龄组和青少年组中比例逐渐增高,且与其他手指损伤相比差异有统计学意义(P<0.05);损伤类型主要为软组织损伤和骨折。③治疗方式:以非手术治疗为主,而手术方式主要为清创缝合术,其次为骨折复位固定术。④就诊类型:外院转入患者较初诊于本院患者更需要手术治疗。⑤预后:大部分患儿预后良好,优良率达84.17%,但存在一定的功能障碍和致残率。结论生活中应加强对门(车)窗挤压伤等危险因素的认识及预防;临床上应进一步加强基层医院对儿童手外伤专业知识的培训。

Objective To investigate the clinical characteristics of finger injuries in children,and to provide scientific evidence for the prevention of finger injuries.Methods Between January 2013 to January 2018,the clinical data of 512 children with finger injuries,who admitted and treated in the Affiliated Hospital of Binzhou Medical College,were analyzed retrospectively.Theχ2 test was used to compare the relationship between the indicators in different groups.Results①Injury factor:Most injures were crush injures in the doors and windows,including car doors.With age,lacerations and sports were injuries gradually increased;②Injury type:Middle finger injures were the most common(33.98%)in the preschool group,and the difference was statistically significant compared with other finger injuries(P<0.05);while the proportion of thumb injuries in the school-age group and adolescent group gradually increased,and the difference was statistically significant compared with other finger injuries(P<0.05);the main types of injuries were soft tissue injuries and fractures;③Therapeutic methods:Mostly patients underwent conservative treatment;mostly surgical methods were debridement,followed by fracture reduction and fixation;④Type of treatment:Patients who were referred from an outside institution were more needed for surgery than those first presented to our hospital.⑤Prognosis:Most of the children had a good prognosis with an excellent rate of 84.17%,but there were dysfunctions and disability.Conclusion In daily life,we should strengthen the understanding and prevention of risk factors such as door(car)window crush injuries;Clinically,it is necessary to further strengthen the professional knowledge training of children's finger injuries in primary hospitals.