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“5.12”汶川大地震伤员气性坏疽的早期诊治

Early diagnosis and treatment for patients with clostridial myonecrosis in "5.12" Wenchuan megaseism

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【作者】 张阳德张宗久赵明钢李坚刘蔚东

【Author】 ZHANG Yang-de1,ZHANG Zong-jiu1,ZHAO Ming-gang1,LI Jian2,LIU Wei-dong2(1.National Hepatobiliary and Enteric Surgery Research Center,Ministry of Health,Central South University,Changsha,Hunan 410008,P.R.China;2.Institute of Biomedical Engineering,Central South University,Changsha,Hunan 410008,P.R.China)

【机构】 中南大学卫生部肝胆肠外科研究中心中南大学生物医学工程研究院

【摘要】 目的探讨地震伤致气性坏疽的诊断以及救治方案。方法对"5.12"汶川地震收治的气性坏疽患者的临床表现,诊断及救治情况进行横断面分析。结果18例气性坏疽患者中行伤口扩创、敞开引流5例,截肢术13例,再次扩创8例,伤口延期缝合15例,植皮2例,18例患者创面均得到封闭,16例患者创面完全愈合,发生急性肾功能衰竭1例,骨筋膜室综合征4例。结论早期诊断、隔离,及时正确处理创面,积极治疗并发症以及全身支持治疗能提高地震伤致气性坏疽患者的临床疗效,保留肢体,降低死亡率。

【Abstract】 ObjectiveTo explore the diagnosis and the therapeutic regimen of megaseism-originated clostridial myonecrosis. MethodsClinical manifestation,diagnosis and the rescuing and treating condition of the hospitalized patients with clostridial myonecrosis in"5.12"Wenchuan megaseism were cross-sectionally analysed. Results5 of 18 patients underwent enlarged debridement with open drainage,13 amputation,8 re-enlarged debridement,15 delayed suture of wound and 2 dermatoplasty. The raw surface of 18 patients was completely closed. Acute renal failure(ARF) occurred in 1 case and osteofascial compartment syndrome in 4. ConclusionEarly diagnosis and isolation,prompt and correct debridement,active treating complications and systemic supportive treatment can improve the clinical curative effect in the patients with clostridial myonecrosis originated from Wenchuan megaseism and reserve their limbs and make the mortality lower.

【关键词】 地震气性坏疽救治
【Key words】 megaseismclostridial myonecrosistreatment
  • 【文献出处】 中国现代医学杂志 ,China Journal of Modern Medicine , 编辑部邮箱 ,2008年23期
  • 【分类号】R633.2
  • 【被引频次】3
  • 【下载频次】64
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