地震伤截肢患者的围手术期治疗
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摘要
目的:探讨地震伤截肢的围手术期治疗方法。方法:2008年5月12日18时~2008年5月30日共行地震伤截肢手术治疗37例,31例单侧下肢截肢,6例单侧上肢截肢;膝上截肢18肢,膝下截肢10肢,半足截肢3例;按Waganer分类:Ⅳ级23例,Ⅴ级14例。结果:37例中愈合34例,伤口感染4例,死亡0例。其中甲级愈合31例,甲级愈合率83%。术后再截肢2例,残端修整2例。结论:地震截肢存在多种并发症,合理的围手术期治疗是手术成功的关键。
Objective:To explore the therapeutic methods for patients with amputation caused by earthquake injury during perioperative period.Methods:37 cases of patients with serious damage of limbs in Wenchuan earthquake were amputated from May 12th to 30th,2008.Among them,31 cases received single side amputation on lower limbs and 6 cases received same operation on upper limbs.18 legs were amputated above knees,10 legs below knees,and 3 feet were semi-foot amputated.According to Waganer's classification,23 patients were type Ⅳ and 14 patients were type Ⅴ.Results:34 cases healed,4 cases suffered from wound infection and no case died among all patients.In addition,wounds of 31 cases had grade A healing and the healing rate of grade A was 83%.Two patients underwent another amputation after the first operation and two patients had stump chipping.Conclusion:Patients with amputation caused by earthquake injury had many complications.Reasonable treatment during perioperative period is the key to surgical success.
Objective:To explore the therapeutic methods for patients with amputation caused by earthquake injury during perioperative period.Methods:37 cases of patients with serious damage of limbs in Wenchuan earthquake were amputated from May 12th to 30th,2008.Among them,31 cases received single side amputation on lower limbs and 6 cases received same operation on upper limbs.18 legs were amputated above knees,10 legs below knees,and 3 feet were semi-foot amputated.According to Waganer's classification,23 patients were type Ⅳ and 14 patients were type Ⅴ.Results:34 cases healed,4 cases suffered from wound infection and no case died among all patients.In addition,wounds of 31 cases had grade A healing and the healing rate of grade A was 83%.Two patients underwent another amputation after the first operation and two patients had stump chipping.Conclusion:Patients with amputation caused by earthquake injury had many complications.Reasonable treatment during perioperative period is the key to surgical success.
引文
(1)陈亚冠,曹烨民,陈强,等.老年重症糖尿病足坏疽截肢的围手术期治疗分析[J].中国骨伤,2006,19(6):333-334.
(2)谢明水,晏文强,熊建华.手术切口感染的病原菌分布及耐药性探讨[J].中华医院感染学杂志,2008,6:874-876.
(3)郭义柱,张伯勋,梁雨田,等.截肢时神经断端肌肉内埋入预防残端神经瘤[J].中国临床康复,2003,20:2850-2851.
(4)汪琴,吴杰凤,冯莉,等.截肢后幻肢痛的综合康复治疗[J].中国临床康复,2004,8:1408-1409.
(2)谢明水,晏文强,熊建华.手术切口感染的病原菌分布及耐药性探讨[J].中华医院感染学杂志,2008,6:874-876.
(3)郭义柱,张伯勋,梁雨田,等.截肢时神经断端肌肉内埋入预防残端神经瘤[J].中国临床康复,2003,20:2850-2851.
(4)汪琴,吴杰凤,冯莉,等.截肢后幻肢痛的综合康复治疗[J].中国临床康复,2004,8:1408-1409.
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