“5·12”汶川地震华西医院收治患者上肢伤情分析
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摘要
[目的]探讨地震上肢伤员的伤情及救治情况。[方法]收集地震期间本院收治236例上肢患者的基本情况,分析上肢患者的受伤机制、临床表现及处理和预后等情况。[结果]236例上肢患者中骨折208例378例次,其中锁骨骨折35例次,肩胛骨骨折31例次,肱骨骨折113例次,尺骨骨折46例次,桡骨骨折87例次,腕掌指骨骨折66例次。开放性骨折64例次。行清创缝合(含扩创)50例次,骨折复位内固定60例次,外固定支架7例次,截肢(含残端修整)19例次,神经血管修复术8例次,保守治疗(石膏托或卧床等)113例次,仅1例病人因高血钾合并颅脑腹部脏器损伤死亡。[结论]分析本次地震中上肢伤的受伤机制、部位等以及伤后救援、治疗、预后等情况,为以后地震及类似情况上肢伤的救治提供参考。
[Objective]To discuss the injury severity and treatment of 236 patients with upper limb injuries in Wenchuan Earthquake.[Method]The basic informations of patients with upper limb injures in Wenchuan Earthquake,and the injury mechanisms,clinical symptoms and treatment were collected and analyzed.[Result]In 236 cases of patients with upper limb injuries,there were 208 patients,378 cases with fracture,and 64 cases with open fracture.There were 35 cases of clavicle fracture,31 cases of scapula fracture,113 cases of humerus fracture,46 cases of ulna fracture,87 cases of radial fracture and 66 cases of carpometacarpai phalangeal fracture.Fifty cases received debridement and suture,60 cases received fracture reduction and internal fixation and 7 cases received external fixation.Totally,19 limbs were carried on amputation,and only one patient died of hyperkalemia and combined injury.[Conclusion]Analysis of patients with injury mechanisms,clinical symptoms and treatment can provide advices for rescuing and treating of patients with upper limb injuries in earthquake or other disaster cases.
[Objective]To discuss the injury severity and treatment of 236 patients with upper limb injuries in Wenchuan Earthquake.[Method]The basic informations of patients with upper limb injures in Wenchuan Earthquake,and the injury mechanisms,clinical symptoms and treatment were collected and analyzed.[Result]In 236 cases of patients with upper limb injuries,there were 208 patients,378 cases with fracture,and 64 cases with open fracture.There were 35 cases of clavicle fracture,31 cases of scapula fracture,113 cases of humerus fracture,46 cases of ulna fracture,87 cases of radial fracture and 66 cases of carpometacarpai phalangeal fracture.Fifty cases received debridement and suture,60 cases received fracture reduction and internal fixation and 7 cases received external fixation.Totally,19 limbs were carried on amputation,and only one patient died of hyperkalemia and combined injury.[Conclusion]Analysis of patients with injury mechanisms,clinical symptoms and treatment can provide advices for rescuing and treating of patients with upper limb injuries in earthquake or other disaster cases.
引文
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[8]李盛华,张彦军,叶丙霖,等.“5.12”地震陇南灾区上肢骨折情况调查与分析[J].甘肃中医,2008,12:5-6.
[9]Brundage SI,McGhan R,Jurkovich GJ,et al.Timing of femur fracturefixation:effect on outcome in patients with thoracic and head injuries[J].Trauma,2002,52:299-307.
[10]王斌,贺西京,刘坚义.骨折急诊手术对多发伤治疗的影响[J].中华创伤杂志,2003,19:389-391.
[11]罗飞,王序全,周强.汶川大地震中伤员阶梯救治原则探讨[J].中华创伤杂志,2008,8:583-586.
[2]李饮柱,亓逢君,卢书锋,等.显微外科修复闭合性腘动脉损伤19例[J].实用骨科杂志,2004,2:180.
[3]Cak ir O,Subasi M,Erdem K,et al.Treatment of vascular injuries as-sociated with limb fractures[J].Ann R Coll Surg Engl,2005,5:348-352.
[4]Iriz E,Kolbakyr F,Sarac A,et al.Ret respective assessment of vascu-lar omkiroes:23 years of experience[J].Ann Thorac CardiovascSurg,2004,6:373-378.
[5]徐佩卿.地震伤亡分析[J].中华医院管理杂志,1994,5:311.
[6]Tahmasebi MN,Kiani K,Mazlouman SJ,et al.Musculoskeletal inju-ries associated with earthquake.A report injuies of Iran's December26,2003 Bam earthquake casualties managed in tertiary referral cen-ters[J].Injury,2005,1:27-32.
[7]孙志刚.地震伤员及医疗救援的调查研究[D].第一军医大学硕士学位论文,2001,1.
[8]李盛华,张彦军,叶丙霖,等.“5.12”地震陇南灾区上肢骨折情况调查与分析[J].甘肃中医,2008,12:5-6.
[9]Brundage SI,McGhan R,Jurkovich GJ,et al.Timing of femur fracturefixation:effect on outcome in patients with thoracic and head injuries[J].Trauma,2002,52:299-307.
[10]王斌,贺西京,刘坚义.骨折急诊手术对多发伤治疗的影响[J].中华创伤杂志,2003,19:389-391.
[11]罗飞,王序全,周强.汶川大地震中伤员阶梯救治原则探讨[J].中华创伤杂志,2008,8:583-586.
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