手部创伤及手术后早期肿胀的综合治疗  

Treatment of traumatic and early postoperative swelling of the hand

作　　者：成本强[1] 区国集[1] 陈友明[1] 龙朝仪[1] 李海平[1] 孔志强[1] 

机构地区：[1]肇庆市第一人民医院骨外科,广东526021

出　　处：《中华手外科杂志》2005年第2期99-100,共2页Chinese Journal of Hand Surgery

摘　　要：目的探讨采用综合治疗方法治疗手部创伤及手术后早期肿胀的效果。方法对伤后2h至2 4h的80例手部创伤后早期肿胀者(其中3 4例闭合性损伤,46例开放性损伤行急诊手术后) ,进行抬高患肢、静脉滴注β七叶皂甙钠和小剂量甘露醇的综合治疗。用药后观察有无不良反应及手指血循环1周,并复查肝肾功能。肿胀程度按顾玉东的分级,Ⅱ级12例,Ⅲ级40例,Ⅳ级2 8例。结果80例中,显效5 1例,有效2 8例,无效1例,总有效率为98.8%。未发现严重副作用、手部骨筋膜间室综合征及肝肾功能异常。17例出现局部刺激性疼痛,3例产生静脉炎,1例出现过敏性皮疹,经停药和对症处理后治愈。结论采用上述综合方法治疗手部创伤及手术后早期肿胀,具有简便易行,快速消肿,无严重并发症等优点,值得临床推广应用。Objective To investigate the effect of combined therapy for treatment of traumatic and postoperative hand swelling. Methods 80 cases of hand swelling that occurred 2 to 24 hours after trauma were treated with combined therapy. 34 cases were close injuries, while 46 cases were open injuries that underwent emergent surgery. Combined therapy including raising the affected limbs, and intravenous injecting of β-escin and low dosage mannitol were applied. Adverse reactions and blood circulation of the fingers were observed. The hepato-renal function was checked after one week of drug administration.According to Gu's scale, there were 12 cases of grade II swelling, 40 cases of grade III swelling, and 28 cases of grade IV swelling. Obvious downgrading of swelling was seen after the combined therapy. Results The results were found to be good in 51 cases, fair in 28 cases and poor in 1 case. The overall effective rate was 98.8%. Compartment syndrome, abnormal hepato-renal function and other severe side effects were not seen. Other complications included local irritative pain in 17 cases, phlebitis in 3 cases, and allergic eruption in 1 case, which were cured after drug withdrawal. Conclusion The combined treatment is a simple, effective and quick method in treating traumatic and postoperative hand swelling. It could be widely used in clinic.

关 键 词：术后早期肿胀 手部创伤 骨筋膜间室综合征 β-七叶皂甙钠 综合治疗方法 小剂量甘露醇 肝肾功能异常 闭合性损伤 开放性损伤 无不良反应 局部刺激性 过敏性皮疹 严重并发症 静脉滴注 药后观察 总有效率 对症处理 推广应用 

分 类 号：R658[医药卫生—外科学]