严重会阴部挫裂伤治疗方案探讨  

The therapeutic regimen for serious perineal laceration

作　　者：于清[1] 张艳[1] 段妍[1] 

机构地区：[1]内蒙古医学院附属医院美容整形烧伤外科,010050

出　　处：《中华损伤与修复杂志（电子版）》2007年第4期216-218,共3页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨会阴部严重挫裂伤治疗的合理方案,提高治疗质量。方法通过回顾我院收治的18例会阴部严重挫裂伤病例的治疗过程,总结与分析了这类损伤不宜Ⅰ期修复的原因和结肠造瘘术在治疗中的作用。结果本组18例会阴部严重挫裂伤,均在早期清创缝合修复,后因感染,同时并发不同程度、不同范围的皮肤坏死而造成缺损和伤口裂开。均需再次清创、皮瓣转移和植皮予以修复。在此过程中,采用结肠造瘘术来控制创面感染和预防创面继发感染,收到了良好效果。结论严重会阴部挫裂伤创面的早期治疗,特别是污染重、挫伤重、损伤范围大的,均不宜Ⅰ期修复。早期行结肠造瘘术对预防和控制会阴部创面感染能起到重要的作用。Objective To discuss the potential solutions for the treatment of serious perineal laceration and to improve the quality of clinical management. Methods The reasons why the severe perineal laceration has poor outcome and the function of colostomy in treatment were summarized and analyzed by reviewing 18 cases under the process of treatment. Results 18 cases with serious perineal laceration by early debridement suture were analyzed. All cases were suffered from various degrees of dehiscence wounds and some complications such as cutaneous necrosis and skin defections. Colostomy was conducted to avoid fecal contamination and prevent secondary infection. Good outcomes were achieved. Conclusion Because of the skin damage in different degrees and scopes, the severe perineal laceration wounds were difficult to get primary repair, especially for those with large and wide scope pollution. In order to prevent secondary infection of the wound, it is necessary to conduct colostomy as soon as possible.

关 键 词：会阴部挫裂伤 治疗方案 结肠造瘘 

分 类 号：R64[医药卫生—外科学]