Reamy B V
Department of Family Practice, David Grant Medical Center, Travis Air Force Base, CA 94535, USA.
J Am Board Fam Pract. 1998 Jan-Feb;11(1):34-40. doi: 10.3122/15572625-11-1-34.
A literature review was conducted to analyze developments in the epidemiology, pathogenesis, treatment, and prevention of frostbite injury. Increased participation in outdoor activities, as well as the epidemic of homelessness, makes knowledge of the treatment of frostbite crucial for physicians in both rural and urban areas.
A literature search, using the key words "frostbite" and "cold," was done using MEDLINE and Index Medicus. This search focused on the epidemiology, pathogenesis, treatment, and prevention of frostbite.
Research done during the past 15 years has clarified the pathogenesis of frostbite injury and led to a better understanding of how to limit tissue loss. The etiology of frostbite is commonly related to alcohol use, psychiatric illness, or motor vehicle problems. The pathogenesis is linked to tissue freezing, hypoxia, and the release of inflammatory mediators. The initial clinical manifestations of frostbite injury are similar for superficial and deep tissue damage, so early treatment is identical for all injuries. Optimum therapy is based on the rapid reversal of tissue freezing by rewarming in 104-108 degrees F water and the institution of oral and topical antiprostaglandin therapy to limit the release of inflammatory mediators.
Rapid triage and treatment of frostbite can lead to dramatic improvements in outcome and prognosis. Increased awareness of antiprostaglandin therapy and preventive measures is crucial for physicians in diverse practice environments.
进行了一项文献综述，以分析冻伤的流行病学、发病机制、治疗和预防方面的进展。户外活动参与度的增加以及无家可归者的增多，使得冻伤治疗知识对于农村和城市地区的医生而言至关重要。
使用关键词“冻伤”和“寒冷”，通过医学文献数据库（MEDLINE）和医学索引进行文献检索。该检索聚焦于冻伤的流行病学、发病机制、治疗和预防。
过去15年的研究已阐明冻伤的发病机制，并使人们对如何限制组织损伤有了更好的理解。冻伤的病因通常与饮酒、精神疾病或机动车问题有关。发病机制与组织冷冻、缺氧以及炎症介质的释放相关。浅表和深部组织损伤的冻伤初始临床表现相似，因此所有损伤的早期治疗相同。最佳治疗方法是通过在104 - 108华氏度的水中复温迅速逆转组织冷冻，并采用口服和局部抗前列腺素疗法来限制炎症介质的释放。
冻伤的快速分诊和治疗可显著改善结局和预后。提高对抗前列腺素疗法和预防措施的认识对于不同执业环境中的医生至关重要。
