重度骨盆骨折外固定及骨盆填塞术后腹部感染13例剖析.docVIP

重度骨盆骨折外固定及骨盆填塞术后腹部感染13例剖析 　　摘 要 目的： 分析重度骨盆骨折行外固定及骨盆填塞术后腹部感染的特点并探讨相应的防治措施。方法： 总结苏州大学附属第三医院18例行外固定及骨盆填塞术治疗的重度骨盆骨折患者的临床资料，分析其中并发腹部感染的情况。结果：18例患者术后有13例出现腹部感染，其中单处感染7例，两处以上感染6例；按感染部位分类：切口感染6例，盆腔感染5例，尿路感染6例，膈下感染1例。13例患者中1例出现腹部广泛感染，最终死于脓毒血症，其余均好转出院。结论：外固定后骨盆填塞是重度骨盆骨折早期治疗的有效措施，但需要预防和控制术后腹部感染，以提高患者生存率。 　　关键词重度骨盆骨折 外固定 骨盆填塞 腹部感染 　　中图分类号：R683.3 文献标识码：A 文章编号：1006-1533(2011)11-0551-03 　　 　　Analysis of 13 cases of severe pelvic fractures treated by external fixation and pelvic packing with abdominal infection 　　CHEN Yan，XIANG Wei，ZHANG Hai-sheng，LI Xiang，WANG Da-ming，LIU Ning 　　（Department of Emergency，the Third Affiliated Hospital of Soochow University，Changzhou，213003） 　　ABSTRACTObjective: To analyze the feature of abdominal infection in patients who were severe pelvic fractures and treated by external fixation and pelvic packing and provide corresponding measures for prevention and cure. Methods: The clinical data of 18 patients with severe pelvic fractures were retrospectively summarized to analyze the feature of their abdominal infection. Results: Among 18 patients 13 cases occurred postoperative abdominal infection，with 7 cases of single part infection and 6 cases of multiple part infection. According to the infectious sites，the patients with abdominal infection were divided into four groups：with 6 cases of incision infection，5 cases of pelvic infection，6 cases of urinary tract infection and 1 case of subphrenic infection. Of the 13 cases，all patients recovered except one patient who occurred a generalized abdominal infection and eventually died of sepsis. Conclusions: External fixation and pelvic packing are the early effective treatment for severe pelvic fracture patients. However，it is necessary to prevent and control thepostoperative abdominal infection in order to improve the rate of survival. 　　KEY WORDSsevere pelvic fracture；external fixation；pelvic packing；abdominal infection 　　 　　骨盆骨折是急诊科常见的危重疾病，多见于交通事故、工伤意外等，其中高能量创伤导致的不稳定型骨盆骨折常合并有失血性休克和多个脏器的损伤，称为重度骨盆骨折