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手部高压注射伤——一种罕见但确实存在的外科急症

High-Pressure Injection Injury of the Hand-A Rare but True Surgical Emergency.

作者信息

Pertea Mihaela, Luca Stefana, Benamor Malek, Constantinescu Mihai-Codrin, Bulgaru-Iliescu Andra-Irina, Amarandei Alexandru, Moraru Dan-Cristian, Saibi Khairi, Ben Mrad Samar, Filip Alexandru, Filip Nina

机构信息

Department Plastic Surgery and Reconstructive, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

Department of Plastic Surgery and Reconstructive Microsurgery, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania.

出版信息

J Clin Med. 2024 Dec 27;14(1):72. doi: 10.3390/jcm14010072.

Abstract

: The aim is to bring attention to the existence of a rare type of trauma of the hand, high-pressure injection injury, that appears to be minor with negligible signs and symptoms within the first hours after the accident, but in reality, produces significant tissue destruction with severe consequences. Recognizing this type of trauma by medical personnel, understanding the mechanisms involved, and knowing the etiological and prognostic factors can lead to early treatment initiation and avoid severe mutilating sequelae. : A retrospective study on 16 patients diagnosed with high-pressure injection injuries, including water, air, paint, paint mixed paint with thinner, petroleum jelly, and lime (washable paint containing calcium oxide). The patients' epidemiological data, the time from accident to diagnosis, reasons for delayed diagnosis, treatments applied, and outcomes were recorded and evaluated. : All injuries occurred at the workplace due to negligence. Oil-based paint was implicated in 31.25% of cases. The most frequently affected anatomical region was the volar surface of the distal phalanx of the nondominant hand index finger. In one case, delayed presentation to medical care and diagnosis resulted in a compartment syndrome, requiring amputation. : It is crucial to recognize and understand this type of trauma, as it constitutes an emergency due to its rapid progression. Delayed diagnosis can result in massive tissue destruction, potentially leading to the loss of limb segments and debilitating functional sequelae, which may severely impact a patient's socio-professional life.

摘要

目的是引起人们对一种罕见的手部创伤——高压注射伤的关注。这种创伤在事故发生后的最初几个小时内看似轻微,体征和症状可忽略不计,但实际上会造成严重的组织破坏并产生严重后果。医务人员识别这种创伤类型、了解其中涉及的机制以及知晓病因和预后因素,可促使尽早开始治疗并避免严重的致残后遗症。

对16例被诊断为高压注射伤的患者进行回顾性研究,注射物质包括水、空气、油漆、油漆与稀释剂的混合物、凡士林和石灰(含氧化钙的可洗漆)。记录并评估患者的流行病学数据、从事故到诊断的时间、延迟诊断的原因、所采用的治疗方法及结果。

所有损伤均因工作场所的疏忽而发生。油性漆导致的病例占31.25%。最常受影响的解剖区域是非优势手示指远节指骨的掌面。有1例因延迟就医和诊断导致骨筋膜室综合征,需要截肢。

识别和了解这种创伤至关重要,因为其进展迅速,属于急症。延迟诊断可导致大量组织破坏,可能导致肢体部分丧失和严重的功能后遗症,这可能会严重影响患者的社会职业生活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad80/11721198/8343050afd2b/jcm-14-00072-g001.jpg

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