地震闭合性软组织挤压伤伤情特点及救治体会
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摘要
目的探讨地震闭合性软组织挤压伤的特点和救治方法。方法分析5.12汶川大地震126例闭合性软组织挤压伤患者的临床资料。结果挤压时间<2小时的66例中轻度伤46例(69.7%),中度伤17例(25.8%),重度伤3例(4.5%);挤压时间3~8小时的31例中轻度伤8例(25.8%),中度伤14例(45.2%),重度伤9例(26.0%);挤压时间>24小时的29例中轻度伤3例(10.3%),中度伤7例(24.1%),重度伤19例(65.5%)。挤压时间越短,伤情越轻;受挤压时间越长,伤情越重。结论地震闭合性软组织挤压伤伤情程度与打压重量和挤压缺血时间有关;肌肉坏死特点是表面皮肤正常深层肌肉坏死,肌肉坏死范围广泛而界限不清,同一块肌肉的坏死肌肉束与正常肌肉束交织在一起,坏死面积浅层小深层大,坏死程度浅层重深层轻。
Objective To investigate the characteristics and treatment methods of closed soft tissue crush injury injured in earthquake.Methods The wounded features of the closed soft tissue injury of 126 cases injured in the 5.12 Wenchuan earthquake and hospitalized in our hospital were analysed.Results The crushing time was less than 2 hours in 66 cases,in whom minor injury was documented in 46 cases(69.7%),moderate injury in 17 cases(25.8%),and severe injury in 3 cases(4.5%).Among the 31 cases whose crushing time was 3-8 hours,mild injury was in 8 cases(25.8%),moderate injury in 14 cases(45.2%),and severe injury in 9 cases(26.0%).Among the 29 cases with the crushing time over 24 hours,3 cases belonged to mild injury(10.3),7 moderate injuries(24.1%),and 19 severe injuries(65.5%).Conclusion The degree of the severity of the closed soft tissue crush injury is related to the crushed weight and the length of ischemic time.The characteristics of muscular necrosis are that the skin surface is normal but the deep layer muscle necrosed with a wide and obscure margin;the necrosis muscle bundle is interlaced with normal muscle bundle in the same muscle;the dimension of necrosis is small at the surface and large at the deep layer;the muscle necrosis of the surface is more serious than the deep layer.
Objective To investigate the characteristics and treatment methods of closed soft tissue crush injury injured in earthquake.Methods The wounded features of the closed soft tissue injury of 126 cases injured in the 5.12 Wenchuan earthquake and hospitalized in our hospital were analysed.Results The crushing time was less than 2 hours in 66 cases,in whom minor injury was documented in 46 cases(69.7%),moderate injury in 17 cases(25.8%),and severe injury in 3 cases(4.5%).Among the 31 cases whose crushing time was 3-8 hours,mild injury was in 8 cases(25.8%),moderate injury in 14 cases(45.2%),and severe injury in 9 cases(26.0%).Among the 29 cases with the crushing time over 24 hours,3 cases belonged to mild injury(10.3),7 moderate injuries(24.1%),and 19 severe injuries(65.5%).Conclusion The degree of the severity of the closed soft tissue crush injury is related to the crushed weight and the length of ischemic time.The characteristics of muscular necrosis are that the skin surface is normal but the deep layer muscle necrosed with a wide and obscure margin;the necrosis muscle bundle is interlaced with normal muscle bundle in the same muscle;the dimension of necrosis is small at the surface and large at the deep layer;the muscle necrosis of the surface is more serious than the deep layer.
引文
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[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,2008,10(6):510-512.
[3]Fleischmann W,strecker W,Bombell M,et al.Vaccum sealing as treat-ment of soft tissue damage in open fracture[J].Ufallchirurg,1993,96(5):488.
[2]姜正明,张承铭,钱伟,等.严重挤压伤5例救治体会[J].中华临床新医学,2002,2(7):645-646.
[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,2008,10(6):510-512.
[3]Fleischmann W,strecker W,Bombell M,et al.Vaccum sealing as treat-ment of soft tissue damage in open fracture[J].Ufallchirurg,1993,96(5):488.
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