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上肢贯通伤——患病率与病因

Penetrating Wounds of the Upper Extremity - Prevalence and Etiology.

作者信息

Erazo Jaime Piccaro, Sabongi Rodrigo Guerra, Moares Vinicius Ynoe de, Santos João Baptista Gomes Dos, Faloppa Flávio, Belloti João Carlos

机构信息

Disciplina de Cirurgia da Mão e do Membro Superior, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2019 Apr;54(2):134-139. doi: 10.1016/j.rbo.2017.12.017. Epub 2019 May 10.

Abstract

To define the major epidemiological features of upper limb penetrating injuries, as well as to identify the causes and the frequency of these lesions at the Instituto de Ortopedia e Traumatologia, a hand surgery center in the city of São Paulo, state of São Paulo, Brazil.  The present study was based on a sample of consecutive patients from our orthopedics and traumatology institute from May 2014 to May 2016. Data were collected by telephone, and a prestructured questionnaire regarding data and features of the lesions was applied. Descriptive statistics and proportions comparison with the chi-squared test were performed with a -value < 5% considered as statistically significant.  At first, 1,648 records were considered and, after applying the exclusion criteria and eliminating duplicate records, 598 records were included in the present study. Most of the patients were male (77.8%), right-handed (95.82%), with an average age of 37.27 years old. Manual laborers were the most injured individuals (50.00%), and fingers were the most affected site (51.84%). Glass was the most frequent etiologic agent (33.77%). The prevalence of amputation was higher in industrial machinery injuries (  < 0.05) when compared with other causes. Younger patients (< 18 years old) had more glass-related injuries, while older patients (≥ 60 years old) had more traumas caused by power tools (  < 0.05). Women had more injuries resulting from razors and glass (  < 0.05). Manual laborers had a higher frequency of power tools and industrial machinery-related injuries (  < 0.05) and a higher prevalence of amputations (  < 0.05).  The most frequent etiology was glass, especially in individuals < 18 years old. Women and older patients (> 60 years old) presented a high frequency of traumas caused by razors and power tools, respectively. More severe injuries were caused by machinery and were related with work activity.

摘要

为明确上肢穿透伤的主要流行病学特征,以及确定巴西圣保罗州圣保罗市手外科中心——骨科与创伤研究所这些损伤的病因及发生频率。

本研究基于2014年5月至2016年5月期间来自我们骨科与创伤研究所的连续患者样本。通过电话收集数据,并应用一份关于损伤数据和特征的预结构化问卷。进行描述性统计以及使用卡方检验进行比例比较,P值<5%被视为具有统计学意义。

起初,考虑了1648份记录,在应用排除标准并消除重复记录后,本研究纳入了598份记录。大多数患者为男性(77.8%),惯用右手(95.82%),平均年龄为37.27岁。体力劳动者是受伤最多的人群(50.00%),手指是受影响最严重的部位(51.84%)。玻璃是最常见的病因(33.77%)。与其他病因相比,工业机械损伤导致截肢的患病率更高(P<0.05)。年轻患者(<18岁)玻璃相关损伤更多,而老年患者(≥60岁)动力工具导致的创伤更多(P<0.05)。女性因剃须刀和玻璃导致的损伤更多(P<0.05)。体力劳动者动力工具和工业机械相关损伤的发生率更高(P<0.05),截肢的患病率也更高(P<0.05)。

最常见的病因是玻璃,尤其是在<18岁的人群中。女性和老年患者(>60岁)分别因剃须刀和动力工具导致的创伤频率较高。机械造成的损伤更严重,且与工作活动有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b69/6529320/6be167325c5a/10-1016-j-rbo-2017-12-017-i170394en-1.jpg

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