摘要
目的探讨外伤性肢体毁损伤急诊截肢的术前急救准备措施以及术中注意事项。方法对2000-2007年收治的43例肢体损毁伤患者治疗情况进行回顾性分析。结果43例均行急症截肢,共47个肢体,其中前臂2例,上臂5例,肩关节离断2例,足部4例,小腿10例,大腿18例,骨盆离断2例。皆为GustiloⅢC型或ⅢB型损伤,术中32例输入全血或者红细胞悬液,占74%。术中均给予胶体以及晶体扩容,除前臂毁损伤外其余均采用全麻,手术时间1.2 3 h。1例因挤压综合症、急性肾功能衰竭而死亡;1例急性肾功能衰竭而死亡。结论对于肢体毁损伤应该在排除致命复合伤后,迅速判断肢体毁损严重程度上,迅速做好术前准备,术中要妥善处理残端,以利于患者康复。
Objective To discuss the general data of （destructive） traumatic limb injuries and review the measures of preparation involved prior to the operation of emergency amputation and the precautions in the course of operation. Method Retrospective analysis of the collected 43 cases of （destructive） traumatic limb injury treated in Anhui Provincial Hospital during 2000 -2007 was conducted. Result 47 limbs （forearm： 2, upper arm： 5, shoulder joint： 2, foot： 4, calf： 10, thigh： 18, pelvis： 2）wereinvolvedinthese43 cases, all belonging to the injury of Gustilo ⅢB or Gustilo ⅢC. 32 patients （74% of all the cases） accepted blood transfusion in the form of whole blood or CRCs and in the course of their operation were treated by the extension of colloid and crystal. General anesthesia was bestowed on them except for traumatic antebrachium, and their operation time varied from 1.2 to 3 hours. 1 case died from crush syndrome and acute renal failure and 1 ease from acute renal failure. Conclusion Regarding （destructive） traumatic limb injuries, a swift diagnosis of injury type and efficient preparation for the operation is highly expected subsequent to the exclusion of fatal complex injuries. And proper treatment of stump in the course of operation is also beneficial to the recovery of patients.
出处
《职业卫生与病伤》
2008年第4期196-197,共2页
Occupational Health and Damage
关键词
外伤
肢体毁损伤
截肢
急救
Traumatic
Destructive traumatic limb
Amputation
Emergency treatment
