手指冲压伤的临床特点与早期处理—附701例分析  

Clinical features and early management of finger crush injuries: analysis of 701 cases

作　　者：李世民[1] 周艳玲[1] 余业文[1] 石惠文[1] 王夫平[1] 周健辉[1] 林戈亮[1] 韦展图[1] 

机构地区：[1]广东省中山市小榄人民医院手外科,528415

出　　处：《中华手外科杂志》2005年第3期162-164,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨手指冲压伤所致复合组织损伤的临床特点与早期处理的措施。方法分析2003年8月-2004年8月收治的701例(1084指)手指冲压伤患者的诊治过程,按伤情特点及损伤程度,分成冲切型、压砸型、冲压混合型和热压型损伤等4种类型。根据不同损伤类型分别采用残端修整、复合组织修复、植皮或皮瓣、手指再植或再造、延迟二期修复等手术方法。结果术后随访14d～7个月,平均4个月。伤口Ⅰ期愈合:冲切型损伤570例,压砸型60例,冲压混合型44例和热压型8例;术后结合康复训练,冲切型损伤术后手指在外形及功能上疗效满意,而后三种类型术后手功能恢复较差。结论手指冲压伤多为复合性损伤,应根据不同损伤类型,选择合适的治疗手法,降低致残率,提高修复效果。Objective To present the clinical features of finger crush injuries and discuss its early management. Methods 701 cases of crush injury of the fingers treated from August 2003 to August 2004 were involved in the study. The injuries were categorized according to characteristics and severity of the trauma and corresponding treatment was proposed. Results These cases were classified into 4 categories: crush cut, press crush,crush, and thermo-crush. As a result of which, different repair methods were adopted including debridement, stump revision, skin graft, flap transfer, free flaps, finger replantation or reconstruction, and two-stage reconstruction. Postoperative rehabilitation followed. Both satisfactory appearance and function were gained. Conclusion Almost all crush injuries of the fingers are combined injuries. One should choose different repair methods so as to lower the deformity rate and gain more function.

关 键 词：早期处理 临床特点 压伤 2003年8月 损伤类型 2004年 手功能恢复 复合性损伤 组织损伤 诊治过程 方法分析 损伤程度 伤情特点 残端修整 组织修复 手指再植 手术方法 二期修复 术后随访 Ⅰ期愈合 康复训练 治疗手法 修复效果 

分 类 号：R658[医药卫生—外科学]