“5·12”汶川地震伤员截肢时机对预后的影响
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摘要
目的探讨地震灾害群体伤事件时,伤员截肢的时机对术后伤员康复的影响。方法地震伤住院病员中有22例不同部位肢体截肢,按截肢时间分为急诊截肢组18例和延迟截肢组4例,对比分析截肢时机对术后伤口愈合、感染、二次截肢、术后并发症、特殊感染的影响。结果两组术后切口感染率比较,差异有显著性意义(P<0.01);并发症发生率比较,差异有显著性意义(P<0.05);术后感染后二次截肢率比较,差异无显著性意义(P>0.05);特殊感染发生率比较,差异无显著性意义(P>0.05)。结论地震灾害群体伤事件时,有截肢指征的伤员在入院后12小时内截肢能有效降低伤员术后伤口感染率及并症发生率,提高医疗救治质量。
Objective To investigate the proper amputation time and its impact on the postoperative rehabilitation of the amputees injured in the natural disaster.Methods Retrospectively analysed the clinical data of 22 hospitalized patients.They were divided into two groups,according to the interval from hospitalization to amputation within or beyond 12 hours.The relationship between the time to amputation and the wound healing,wound infections,re-amputation,postoperative complications,and other specific infections was analysed.Results The postoperative wound infections,and the complications of the two groups had significant difference(P < 0.05),whereas the re-amputation due to postoperative infections and the incidence of specific infections of the two groups had no significant difference(P > 0.05).Conclusion Amputation within 12 h after injury is better than those of more than 12 h.
Objective To investigate the proper amputation time and its impact on the postoperative rehabilitation of the amputees injured in the natural disaster.Methods Retrospectively analysed the clinical data of 22 hospitalized patients.They were divided into two groups,according to the interval from hospitalization to amputation within or beyond 12 hours.The relationship between the time to amputation and the wound healing,wound infections,re-amputation,postoperative complications,and other specific infections was analysed.Results The postoperative wound infections,and the complications of the two groups had significant difference(P < 0.05),whereas the re-amputation due to postoperative infections and the incidence of specific infections of the two groups had no significant difference(P > 0.05).Conclusion Amputation within 12 h after injury is better than those of more than 12 h.
引文
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[2]范伟力,柳峰,朱军,等.震区四肢骨折病人感染后方治疗[J].创伤外科杂志,2008,9(10):404-405.
[3]柳峰,赵建华,王爱民,等.德阳地区地震致骨伤伤情及处理分析[J].创伤外科杂志,2008,9(10):402-403.
[4]蒲虹,金小东,邓一芸,等.“5.12”四川汶川特大地震伤员多器官功能障碍综合征的特征与处理[J].中国危重病急救医学,2009,21(1):29-31.
[5]徐少文,张茂.提高对挤压综合征的认识和救治水平[J].中华急诊医学杂志,2008,9(17):901-903.
[6]周玉波,曾俊,胡卫建.地震伤并发挤压综合征的救治分析[J].中华急诊医学杂志,2008,10(17):1016-1018.
[7]张斌,马勇,戴闽,等.关于地震灾害中创伤性截肢平面的探讨[J].中国矫形外科杂志,2008,10(16):1536-1537.
[8]卢世璧.汶川地震伤员救治的几点经验[J].中国矫形外科杂志,2008,10(16):1521-1522.
[9]杨效宁,裴福兴,黄富国,等.地震所致挤压综合征的早期诊治[J].中国矫形外科杂志,2008,10(16):1528-1531.
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