Craigen M, Kleinert J M, Crain G M, McCabe S J
Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY 40202, USA.
J Hand Surg Am. 1999 Jan;24(1):8-15. doi: 10.1053/jhsu.1999.jhsu24a0008.
In this prospective cohort study, we questioned whether cold sensitivity occurring after all types of injuries decreases, increases, or remains constant. We also questioned which patient and injury characteristics are most associated with the development of cold sensitivity. The degree of cold sensitivity of 123 patients with acute hand and forearm injuries was repeatedly scored from a prevalidated questionnaire over 11 months after injury. Twenty-five patients with more severe symptoms at 11 months were reassessed at 3 years. The patients' age, gender, smoking habit, workers' compensation status, mechanism of injury, level and orientation of injury, and injured structures were analyzed with respect to cold sensitivity. The results of our study indicate that the severity of cold sensitivity increased from the time of injury until 3 months following injury and then remained constant until 11 months following injury. At 3 years from injury, symptoms in patients with severe cold sensitivity had significantly reduced to 67% of the 11-month level. Cold sensitivity was common in all types of hand injuries, not just in amputations and in arterial or nerve injuries. A multiple linear regression analysis suggested that the severity of cold sensitivity was most related to the presence of bone injury. Cold severity was not specifically related to smoking or amputations.
在这项前瞻性队列研究中，我们探究了各类损伤后出现的冷敏感是降低、增加还是保持不变。我们还探究了哪些患者和损伤特征与冷敏感的发生最为相关。在受伤后的11个月内，我们使用一份经过预验证的问卷，对123例急性手和前臂损伤患者的冷敏感程度进行了多次评分。对11个月时症状较为严重的25例患者在3年时进行了重新评估。我们分析了患者的年龄、性别、吸烟习惯、工伤赔偿状况、损伤机制、损伤水平和方向以及受伤结构与冷敏感的关系。我们的研究结果表明，冷敏感的严重程度从受伤时到受伤后3个月增加，然后在受伤后11个月保持不变。在受伤3年时，冷敏感严重的患者症状显著减轻至11个月时水平的67%。冷敏感在所有类型的手部损伤中都很常见，不仅仅是在截肢以及动脉或神经损伤中。多元线性回归分析表明，冷敏感的严重程度与骨损伤的存在最为相关。冷敏感严重程度与吸烟或截肢并无特定关联。
