汶川地震中颜面部创伤的处理原则
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摘要
目的调查分析汶川地震中涉及耳鼻咽喉颜面部外伤伤员的伤情及治疗情况,探讨更有效地处理针对地震造成的颜面部外伤的方法。方法对在解放军第452医院住院治疗的165例汶川地震伤员进行专科检诊,重点对合并耳鼻咽喉颜面部损伤的伤员伤情进行统计分析,并根据伤情分别给予清创缝合或整形缝合、骨折复位及固定、局部及全身抗感染治疗。对其治疗后2周的效果进行随访观察。结果165例伤员中合并颜面部损伤伤员33例(20%),包括耳部外伤10例(6.1%)、鼻部外伤8例(4.8%)、口唇撕裂伤2例(1.2%),经治疗后伤口均一期愈合,无毁容病例;鼻窦及颧骨骨折8例(4.8%)、下颌骨骨折5例(3.0%),治疗后患者恢复良好,目前仍在随访中;无咽喉部、颈部及气管食管外伤者。伤后并发感染者(非院内感染)6例(3.6%),无死亡病例。结论专科医生应早期、恰当地处理地震所造成的颜面部外伤,除了重建功能以外,恢复患者的正常形态(容貌)同样重要。
Objective To investigate and analyze the state of injury and treatment for the patients with maxillofacial injuries in Wenchuan earthquake, and search for more effective methods for treating maxillofacial injury. Methods One hundred and sixty-five patients wounded in Wenchuan earthquake were admitted to authors' hospital, and they received specialized diagnosis and treatment. In this paper, the emphasis was put on those patients with severe ear-nose-throat and maxillofacial injuries. Based on the analysis of the state of injuries, the patients were treated with debridement and suture, reshaping and suture, reduction and fixation of fracture, or local or systematic anti-infection therapy. All the treated patients were followed up 2 weeks after treatment. Results Thirty-three of the 165 admitted patients suffered from various degrees of maxillofacial injury (20.0%), including 10 cases of ear injuries (6.1%), 8 cases of nasal trauma (4.8%) and 2 cases of lip laceration (1.2%). All the wounds healed by primary intention after the treatment with no disfiguration. 8 cases of nasal sinus and zygomatic fractures (4.8%) and 5 cases of mandibular fracture (3.0%) recovered nicely after the treatment. No trauma was found in throat, neck, trachea and esophagus. 6 patients (3.6%) were complicated with infection after injury (onset of infection outside of hospital). There was no death. Conclusion Patients with maxillofacial injury should receive early and appropriate treatment. Besides restoration of function, it is also important to restore the physiognomy
Objective To investigate and analyze the state of injury and treatment for the patients with maxillofacial injuries in Wenchuan earthquake, and search for more effective methods for treating maxillofacial injury. Methods One hundred and sixty-five patients wounded in Wenchuan earthquake were admitted to authors' hospital, and they received specialized diagnosis and treatment. In this paper, the emphasis was put on those patients with severe ear-nose-throat and maxillofacial injuries. Based on the analysis of the state of injuries, the patients were treated with debridement and suture, reshaping and suture, reduction and fixation of fracture, or local or systematic anti-infection therapy. All the treated patients were followed up 2 weeks after treatment. Results Thirty-three of the 165 admitted patients suffered from various degrees of maxillofacial injury (20.0%), including 10 cases of ear injuries (6.1%), 8 cases of nasal trauma (4.8%) and 2 cases of lip laceration (1.2%). All the wounds healed by primary intention after the treatment with no disfiguration. 8 cases of nasal sinus and zygomatic fractures (4.8%) and 5 cases of mandibular fracture (3.0%) recovered nicely after the treatment. No trauma was found in throat, neck, trachea and esophagus. 6 patients (3.6%) were complicated with infection after injury (onset of infection outside of hospital). There was no death. Conclusion Patients with maxillofacial injury should receive early and appropriate treatment. Besides restoration of function, it is also important to restore the physiognomy
引文
[1]Zazzali JL,Marshall GN,Shetty V,et al.Provider perceptions of patient psychosocial needs after orofacial injury.J Oral Maxillofac Surg,2007,65(8):1584
[2]Bagheri SC,Di massi M,Shahriari A,et al.Facial trauma coverage amonglevel-1trauma centers of the United States.J Oral Maxillofac Surg,2008,66(5):963
[3]Hull AM,Lowe T,Devlin M,et al.Psychological consequences of maxillofacial trauma:a preli minarystudy.Br J Oral Maxillofac Surg,2003,41(5):317
[4]Das UM,Nagarathna C,Viswanath D,et al.Management of facial traumain children:Acase report.J Indian Soc Pedod Prev Dent,2006,24(3):161
[5]王晋煌,雷衔君,陈荣剑.颜面部外伤的一期美学修复.中国美容医学,1999,8(3):134
[6]白云冬.头面部外伤326例临床分析.现代中西医结合杂志,2007,12(11):125
[7]刘元波,徐军,穆兰花,等.整形外科学原则和技术在面部外伤处理中的应用.中国实用美容整形外科杂志,2006,6(3):116
[8]谢晓明,程新德,赵天兰,等.整形美容外科技术在急诊面部外伤中的应用.中国美容医,2006,15(10):223
[9]Auerbach SM,Laskin DM,Kiesler DJ,et al.Psychological factors associated with response to maxillofacial injury and its treatment.J Oral Maxillofac Surg,2008,66(4):755
[10]牛百平,叶湘玉,刘建华.对面部畸形忍受程度的测量研究.中华口腔医学杂志,1994,29(4):213
[11]全国第四届口腔颌面外科整形美容外科学术研讨会.实用美容整形外科杂志,1999,30(6):3
[12]姜涛.整形美容外科方法Ⅰ期治疗面部外伤712例的体会.大连医科大学学报,2005,22(2):32
[13]鲁开化,马显杰,郭树忠,等.面部外伤的早期美容修复.中国美容医学,2006,15(4):166
[2]Bagheri SC,Di massi M,Shahriari A,et al.Facial trauma coverage amonglevel-1trauma centers of the United States.J Oral Maxillofac Surg,2008,66(5):963
[3]Hull AM,Lowe T,Devlin M,et al.Psychological consequences of maxillofacial trauma:a preli minarystudy.Br J Oral Maxillofac Surg,2003,41(5):317
[4]Das UM,Nagarathna C,Viswanath D,et al.Management of facial traumain children:Acase report.J Indian Soc Pedod Prev Dent,2006,24(3):161
[5]王晋煌,雷衔君,陈荣剑.颜面部外伤的一期美学修复.中国美容医学,1999,8(3):134
[6]白云冬.头面部外伤326例临床分析.现代中西医结合杂志,2007,12(11):125
[7]刘元波,徐军,穆兰花,等.整形外科学原则和技术在面部外伤处理中的应用.中国实用美容整形外科杂志,2006,6(3):116
[8]谢晓明,程新德,赵天兰,等.整形美容外科技术在急诊面部外伤中的应用.中国美容医,2006,15(10):223
[9]Auerbach SM,Laskin DM,Kiesler DJ,et al.Psychological factors associated with response to maxillofacial injury and its treatment.J Oral Maxillofac Surg,2008,66(4):755
[10]牛百平,叶湘玉,刘建华.对面部畸形忍受程度的测量研究.中华口腔医学杂志,1994,29(4):213
[11]全国第四届口腔颌面外科整形美容外科学术研讨会.实用美容整形外科杂志,1999,30(6):3
[12]姜涛.整形美容外科方法Ⅰ期治疗面部外伤712例的体会.大连医科大学学报,2005,22(2):32
[13]鲁开化,马显杰,郭树忠,等.面部外伤的早期美容修复.中国美容医学,2006,15(4):166
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