小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 受累肢体寒冷或麻木
- 复温期间感到疼痛
- 紫色皮肤变色
- 白色或黄色皮肤斑块
- 浅表皮肤起水疱
- 深紫色水疱
- 组织坏死和干化（干性坏疽）
其他诊断因素
- 红斑
- 关节脱位
- 骨折
危险因素
- 寒冷暴露
- 既往冻伤
- 血管功能不全
- 高海拔
- 缺氧
- 酒精
- 烟草
- 脱水
- 四肢外伤
- 紧缩性服装或设备
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 锝-99m 高锝酸盐核素显像
- 受伤肢体的磁共振血管造影
- 平片影像扫描检查
新兴检查
- 热像图和双面图像
治疗流程
所有患者
撰稿人
作者
Elizabeth A. Kaufman, MD, CAQ-SM
Attending Physician
Scripps Green Hospital
Urgent Care Center
Scripps Clinic
La Jolla
CA
利益声明
EAK declares that she has no competing interests.
Christopher Imray, PhD, FRCS, FRCP, FRGS
Director of Research, Development and Innovation
University Hospital Coventry and Warwickshire NHS Trust
Warwick Medical School
Coventry
UK
利益声明
CI has been paid for medico-legal work as a medical expert and receives royalties of approximately £150 per annum for the Oxford Handbook of Wilderness and Environmental Medicine. CI has spoken pro bono at lectures and other educational events.
鸣谢
Professor Christopher Imray and Dr Elizabeth A. Kaufman would like to gratefully acknowledge Professor Paul S. Auerbach and Dr Claire Turchi, previous contributors to this topic. PSA and CT declare that they have no competing interests.
同行评议者
Luanne Freer, MD, FACEP, FAWM
Medical Director
Yellowstone National Park
WY
Founder/Director
Everest Base Camp Medical Clinic
Nepal
利益声明
LF declares that she has no competing interests.
Grant S. Lipman, MD
Clinical Assistant Professor of Surgery and Emergency Medicine
Associate Director Wilderness Medicine Fellowship
Assistant Research Director
Stanford University School of Medicine
Palo Alto
CA
利益声明
GSL declares that he has no competing interests.
Peter Hackett, MD
Director
Institute for Altitude Medicine
Telluride
CO
利益声明
PH declares that he has no competing interests.
鉴别诊断
- 皮肤烧伤
- 冻结伤
- 雷诺现象
更多 鉴别诊断指南
- 热病和冻伤：医疗管理指南第 2 部分
- 荒野医学协会（Wilderness Medical Society）冻伤预防和治疗临床实践指南：2019 年更新
更多 指南
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