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烧伤病房的截肢手术:对82例患者12年的回顾性分析。

Amputations in the burn unit: A retrospective analysis of 82 patients across 12 years.

作者信息

Li Quan, Wang Ling-Feng, Chen Qiang, Wang Shu-Jie, Li Fang, Ba Te

机构信息

Department of Burns, Third Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Institute of Burn Research, Baotou, Inner Mongolia, China.

Department of Burns, Third Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Institute of Burn Research, Baotou, Inner Mongolia, China.

出版信息

Burns. 2017 Nov;43(7):1449-1454. doi: 10.1016/j.burns.2017.04.005. Epub 2017 Aug 1.

Abstract

BACKGROUND

The aim of this study is to analyze the data of amputees in the burn center of the Inner Mongolia region and to provide instructive suggestions for a preventative reduction of the amputation rate.

METHODS

Between 2004 and 2016, all patient medical profiles were reviewed to extract data of patients with major amputation. Demographic data, mechanism of injury, location and level of amputation were recorded. The healing condition of the residual limb was noted. In addition, we performed comparisons of amputees whose injuries were caused by electricity and those whose injuries were related to other mechanisms.

RESULTS

Among the 82 amputees in our study, about 89% of amputees were male patients and the predominant age-group was 20-29 years (26.8%). The injuries occurred most commonly at the work place (62.2%) with laborers (40.2%) being the most commonly affected. The most common mechanisms of injury were electricity (51.2%) and hot crush (14.6%), followed by frostbite (13.4%). The most common level of amputation was the right wrist joint (n=16). About 60.4% of the amputation sites were by primary healing. The rate of escharotomy in electrical burn amputees (n=27, 62.3%) was significantly higher than the other groups (n=16, 40.0%, p<0.05). The first amputation in electrical burn group (7.2±5.6) was significantly earlier than the other etiology group (17.9±13.7, p<0.05).

CONCLUSIONS

Electrical burns were the major mechanism of injury among amputees. Effective safety measures, factory modifications, and adequate instructions should be implemented to protect laborers. Urgent interdisciplinary communication should be taken into account for the prevention reduction of the amputation rate in our region.

摘要

背景

本研究旨在分析内蒙古地区烧伤中心截肢患者的数据,为预防性降低截肢率提供指导性建议。

方法

回顾2004年至2016年期间所有患者的病历,提取接受大截肢手术患者的数据。记录人口统计学数据、损伤机制、截肢部位和水平。记录残肢的愈合情况。此外,我们对因电损伤导致截肢的患者和因其他机制导致损伤的患者进行了比较。

结果

在我们研究的82例截肢患者中,约89%为男性患者,主要年龄组为20 - 29岁(26.8%)。损伤最常发生在工作场所(62.2%),受影响最常见的职业是劳动者(40.2%)。最常见的损伤机制是电损伤(51.2%)和热挤压伤(14.6%),其次是冻伤(13.4%)。最常见的截肢水平是右腕关节(n = 16)。约60.4%的截肢部位一期愈合。电烧伤截肢患者(n = 27,62.3%)的焦痂切开率显著高于其他组(n = 16,40.0%,p < 0.05)。电烧伤组首次截肢时间(7.2±5.6)明显早于其他病因组(17.9±13.7,p < 0.05)。

结论

电烧伤是截肢患者的主要损伤机制。应实施有效的安全措施、工厂改造和充分的指导以保护劳动者。为降低本地区的截肢率,应考虑进行紧急的多学科沟通。

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