573例多发伤骨折的早期诊断分析  

Timely diagnosis and treatment of multiple traumatic injuries and fractures

作　　者：任鸿[1] 文亮[1] 徐世伟[1] 闫柏刚[1] 

机构地区：[1]第三军医大学西南医院急救部,重庆400038

出　　处：《重庆医学》2008年第24期2763-2764,共2页Chongqing medicine

摘　　要：目的总结多发伤骨折的早期诊治经验,提高多发伤骨折救治水平。方法对2000年1月至2007年1月于西南医院就诊的714例多发伤骨折患者的临床资料进行了回顾性分析。结果(1)全组共死亡24例,死亡率3.36%,其中16例死于颅、脑外伤,2例死于高位截瘫、呼吸衰竭;(2)内固定前2例并发ARDS,合并泌尿系感染及褥疮各5例;(3)骨折达解剖复位者706例,达功能复位者5例,有3例由于复位及固定不理想而行2次手术达到要求;(4)骨折迟延愈合4例,由于胫腓骨下段骨折,伤口感染骨外露,术后伤口感染6例;(5)术后肘关节僵直4例,膝关节僵直5例与早期不合理锻炼有关。结论多发伤骨折同一般创伤相比有着不同的临床特点。早期准确诊断及创伤评估,早期急诊手术固定骨折,可最大限度降低患者死亡率和伤残率。Objective To summarize the experience in the prompt diagnosis and treatments for multiple traumatic injuries and fractures,and to improve the recovery rate from such patients. Methods Clinical data from 714 cases with multiple traumatic inju ries and fractures,hospitalized from January 2000 to January 2007,were reviewed. Results （1） The mortality was 3.36 %, 16 pa tients were died from severe cerebral trauma, 2 patients were died from respiratory failure; （2） 2 patients were complicated with ARDS,5 patients wcre complicated with urinary infection,the other 5 patients were complicated with bedsore; （3） Fractures were anatomically reduced in 706 cases,and functionally reduced in 5 cases. In another 3 cases, fractures were functionally reduced after secondary operation; （4） Delayed union were taken place in 4 cases with multiple fracture in inferior segment of tibia and fibula,due to infection. Wound infection were taken place in 6 cases;（5） 9 patients were suffered from joint stiffness,4 on elbow joint and 5 on knee joint,due to uns.uitable initial training. Conclusion Multiple traumatic injuries and fractures have special clinical characters comparing with common cases. Precise prompt diagnosis and traumatic evaluation, and timely ORF can significantly decrease the mortality and disable rate from multiple traumatic injuries and fractures.

关 键 词：多处创伤 骨折 诊断 治疗 

分 类 号：R641[医药卫生—外科学]