闭合性上肢碾压伤的治疗体会.docVIP

精品论文 参考文献 闭合性上肢碾压伤的治疗体会 梁启善1 郭小惠2 杨小文1 刘明龙1 林钦扬1 陈景涛1 汪平1 肖立罡1(1暨南大学医学院附属深圳华侨医院手足显微外科分院 广东深圳 518111)(2重庆涪陵区郭昌毕骨科医院 重庆 408000) 【摘要】目的 探讨闭合性上肢碾压伤的治疗效果。方法 2004年1月至2012年8月，将30例上肢闭合性碾压伤分三类：一类：皮肤，肌肉碾压伤；二类：肌肉、肌腱断裂伴血管、神经损伤；三类：软组织损伤伴骨关节损伤。急诊行皮肤、筋膜切开，肌肉、肌腱、血管、神经修复，亚急诊延期闭合伤口，早期骨关节复位内固定。结果 按中华手外科学会上肢部分功能评定试用标准评定，优18例，良9例，差3例，优良率90%。结论 积极的急诊切开探查及显微外科治疗，是闭合性上肢碾压伤恢复良好功能的关键。 【关键词】上肢 闭合性损伤 碾压伤 显微外科手术 【中图分类号】R642【文献标识码】A【文章编号】2095-1752（2013）03-0152-02 The treatment experience of closed upper limb crush injury LIANG Qi-shan,GUO Xiao-hui, YANG Xiao-wen,et al (Branch of Hand ,foot and microsurgery, Jinan University Subsidiary Of Shenzhen Overseas Chinese Hospital,Shenzhen,518111,China) 【Abstract】 Objective To explore the closed upper limb crush injury treatment effect. Methods January 2004 to August 2012, 30 cases of upper limb closed crush into three categories. The first category: The skin, muscle crush injury; The second category: Muscle, tendon rupture with vascular, nerve injury；The third category: Soft tissue injury associated with bone and joint injuries. Emergency line of skin and fascia incision.Muscles, tendons, blood vessels, nerve repair.Delayed wound closure. Bone and joint early reduction and internal fixation. Results The survival rat was 95.8%. According to the functional evaluation criteria formulated by Chinese Hand Surgery Society, results were excellent in 18 cases ,good in 9 cases,and poor in 3 cases. The excellent and good rate was 90%. Conclusion Emergency open exploration and microsurgical treatment is the key of closed upper limb crush injury recovery function. 【Key words】 upper limb closed injury mangled injury microsurgery 上肢的活动范围大，受到创伤的机会多。上肢闭会性碾压伤时，如果判定损伤程度不准确，延误手术时机，往往造成肢体功能恢复不佳，甚至功能丧失或截肢。2004年1月至2012年8月，我们将上肢碾压伤分为三类：一类：皮肤，肌肉碾压伤；二类：肌肉、肌腱断裂伴血管、神经损伤；三类：软组织损伤伴骨关节损伤。采取分步治疗，即急诊切开探查，亚急诊修复创面，早期骨关节复位固定。共治疗30例，获得满意效果。 1 资料与方法 1.1一般资料 本组30例，男19例，女11例，年龄20～50岁，平均3