摘要
目的分析小腿GustiloⅢC型损伤的早期修复治疗效果。方法选取2012年3月至2015年1月河北省唐山市第二医院收治的小腿GustiloⅢC型损伤患者20例作为研究对象。早期给予抗休克及相关专科处理，应用显微外科手术技术进行修复，术后给予抗炎、抗凝和抗痉挛治疗。随访观察患者皮瓣成活情况、骨折愈合时间、肢体外观及功能。同时观察并发症发生情况。结果直接皮瓣移植3例，自身静脉桥接移植修复5例，小腿筋膜间隙切开减压9例，3例皮瓣移植患者中出现血管危象1例，及时手术探查处理后皮瓣血运恢复。术后20例患者均获随访，中位随访时间17.5个月，经治疗肢体全部成活。所有患者骨折愈合良好，肢体外观和功能均恢复正常，无相关并发症发生。结论小腿GustiloⅢC型损伤早期诊断、处理至关重要，应用显微外科技术对骨折及软组织损伤的早期修复对创伤治疗的成功起着关键作用。
ObjectiveTo analyze the efficacy of early repair in patients with Gustilo ⅢC type leg injury. MethodsTwenty patients with Gustilo ⅢC type in legs were enrolled from March 2012 to January 2015 in the Second Hospital of Tangshan, Hebei Province. The patients had antishock and specialized treatments for early therapy and had anti-inflammatory, anticoagulant, anticonvulsant treatments after microsurgical operation. Flap survival, fracture healing, body appearance, body function and complications were observed. ResultsThree patients had direct flap transplantation; 5 patients had vein graft transplantation; 9 patients had fascial space incision and decompression. Vascular crisis occurred in 1 patient with flap transplantation; the blood flow of flap recovered after surgical treatment. All patients survived after operation, median follow-up time was 17.5 months. Fractures healed well in all patients; appearance and function of limbs recovered to normal; no complications were observed. ConclusionsEarly diagnosis and treatment are vital for Gustilo ⅢC type leg injury; microsurgical treatments are effective for vascular repair, fracture and soft tissue healing.
出处
《中国医药》
2017年第4期575-578,共4页
China Medicine
