手外伤病因、发病学特点与社会学后果的前瞻性研究  

The causes, characteristics and consequences of hand injuries: A prospective study

作　　者：秦允[1] 刘小林[1] 程钢[1] 向剑平[1] 朱家恺[1] 劳镇国[1] 许扬滨[1] 

机构地区：[1]中山医科大学附属第一医院显微外科,广州510080

出　　处：《中华手外科杂志》2000年第2期90-93,共4页Chinese Journal of Hand Surgery

摘　　要：目的　了解广州及周边经济相对发达地区的急诊手外伤的病因、发病学特点与社会学后果。方法　对 1998年度广州中山医科大学附属第一医院急诊手外伤住院患者 86例 ,进行前瞻性调查和随访分析。结果　中重度手外伤占同期住院治疗的骨科急诊总数的 3 3 .6%。每天在 12～ 18时最易受伤。机械制造业、木工、建筑工和农民是手外伤的高发工种 ;冲压机床、电锯、电刨和刀及摩托车是几种最常见的致伤物。人为因素仍是手外伤发生的主要原因 ,在构成上以工业性手外伤最多。个体私营企业和乡镇企业中的劳动保护制度较差。每例患者的直接医疗费用平均为 $10 5 92元 ,缺岗时间为 12 6.3d。仅有 44.6%患者的手功能可恢复到优良级。结论　在经济相对发达地区手外伤的发病率仍然较高 ,社会学后果严重 ,但发病学特点出现了一些新的变化。因此 ,手外伤的预防工作和劳动保护制仍应加强 ,医疗资源的配置应适应新的情况。Objective To investigate the causes, characteristics and consequences of hand injuries in Guangzhou and its adjacent developed areas. Methods A prospective and follow up study was carried out in 86 in patients of acute hand injuries treated in the First Affiliated Hospital of Guangzhou Sun Yat-Sen University of Medical Sciences during a period of 12 months in 1998. Results Moderate and severe hand injuries accounted for 33.6 % of all orthopedic emergency cases which needed hospitalization. Injuries occurred more frequently between 12:00 to 18:00 p.m. The incidence of hand injuries was higher in machinery workers, carpenters, building workers and farmers. Punch, electric saw and planer, knives and autobikes were the concrete injury objects most frequently seen. Human factors were still prominent in the cause of hand injury. Industrial accidents accounted for 50 % of all hand injuries, being most dominant in the scheme of hand injuries. The laboring protection in private enterprises and village enterprises was worse than that in state owned enterprises and joint ventures. The average medical cost per injury was $10 592 and the average time off work was 126.3 days. Good and excellent recovery of hand function was achieved in 44.6 % patients. Only 66 % patients could return to their former jobs. Conclusions In relatively developed areas, the incidence of hand injuries is still high and the consequences are severe. The etiological characteristics have changed in some respects. Therefore, prevention and laboring protection should be enhanced and the configuration of medical resources should be adapted to these changes.

关 键 词：手损伤 流行病学 前瞻性研究 医学社会学 

分 类 号：R658[医药卫生—外科学]