543例地震骨折术后随访报告
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摘要
[目的]总结大批量地震伤骨折伤员救治方法和预后,分析影响疗效的原因。[方法]介绍本院2008年5.12汶川地震中收治的骨折伤员的主要救治措施和手术方法,随访术后疗效。[结果]平均随访时间13个月,随访率78.4%。525例骨折术后一期愈合(96.7%),延迟愈合和不愈合18例(3.3%),其中开放性骨折16例,闭合性骨折2例,主要发生在胫腓骨(14例),占延迟愈合和不愈合总数的77.8%。感染数46例,感染率8.5%。疗效优352例(64.8%),良108例(19.9%),可51例(9.4%),差32例(5.9%),优良率84.7%。[结论]多学科联合急救分类、合理医师组配和专家组决策手术预案等卫勤组织管理方法,快速、简便、有效、安全的手术原则是提高手术通过量和手术效果的关键。
[Objective]To investigate the treatment and prognosis of a large sample of earthquake injury patients,and to analyze the trauma causes.[Method] All cases were injured in Wenchuan Earthquake.Their post-operative effects were recorded and analyzed.[Result]In all 693 cases,543 cases were followed up for average 13 months,with the follow-up rate of 78.4%.One stage healing was achieved in 525 cases (96.7%).In another 18 cases (3.3%) of nonunion or delayed union cases,16 cases were open fractures and 2 cases were closed fractures.Most of them were tibia and fibula fractures (14 cases,77.8%).Infection occurred in 46 cases (8.5%).Excellent effect were achieved in 352 cases (64.8%),good in 108 cases (19.9%),fair in 51 cases (9.4%),poor in 32 cases (5.9%).The final good-to-excellent rate was 84.7%.[Conclusion]Combination of multiple departments for classification of first-aid,reasonable composition of surgeons,and principles of being quick,convenient,effective and safe are keys to improve operation quality and effect.
[Objective]To investigate the treatment and prognosis of a large sample of earthquake injury patients,and to analyze the trauma causes.[Method] All cases were injured in Wenchuan Earthquake.Their post-operative effects were recorded and analyzed.[Result]In all 693 cases,543 cases were followed up for average 13 months,with the follow-up rate of 78.4%.One stage healing was achieved in 525 cases (96.7%).In another 18 cases (3.3%) of nonunion or delayed union cases,16 cases were open fractures and 2 cases were closed fractures.Most of them were tibia and fibula fractures (14 cases,77.8%).Infection occurred in 46 cases (8.5%).Excellent effect were achieved in 352 cases (64.8%),good in 108 cases (19.9%),fair in 51 cases (9.4%),poor in 32 cases (5.9%).The final good-to-excellent rate was 84.7%.[Conclusion]Combination of multiple departments for classification of first-aid,reasonable composition of surgeons,and principles of being quick,convenient,effective and safe are keys to improve operation quality and effect.
引文
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[6]权毅,潘显明,邓少林,等.汶川特大地震挤压伤的特点与手术方式选择[J].中国修复重建外科杂志,2009,5:549-551.
[7]卢世璧.汶川地震挤压综合症患者肌肉挤压伤的特点[J].中华骨科杂志,2008,10:793-798.
[2]Szydelko M,Kwolek A,Druzhicki M.Results of rehabilitation in pa-tients after subarachnoid haemorrhage from ruptured intracranial an-eurysm and after surgical treatment[J].Neurol Neurochir Poi,2008,2:116-122.
[3]Moriello C,Byme K,Cieza A,et al.Mapping the stroke impact scale(SIS-16)to the international classification of functioning,disability and health[J].J Rehabil Med,2008,2:102-106.
[4]权毅,潘显明,邓冰,等.1070例地震伤救治情况报告[J].中华创伤骨科杂志,2008,6:5105-5112.
[5]潘显明,邓少林,屈波,等,汶川特大地震中脊柱骨折伤员的救治体会[J].中国矫形外科杂志,2009,10:744-746.
[6]权毅,潘显明,邓少林,等.汶川特大地震挤压伤的特点与手术方式选择[J].中国修复重建外科杂志,2009,5:549-551.
[7]卢世璧.汶川地震挤压综合症患者肌肉挤压伤的特点[J].中华骨科杂志,2008,10:793-798.
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