下肢严重开放伤并发气性坏疽的原因分析  

Analysis of cause for gas gangrene complicating severe open leg injury

作　　者：傅庭斌[1] 李颖[1] 杨俊生[1] 牛军涛[1] 周强[1] 

机构地区：[1]解放军第454医院骨科,江苏南京210002

出　　处：《东南国防医药》2009年第3期221-223,共3页Military Medical Journal of Southeast China

摘　　要：目的分析下肢严重开放伤并发气性坏疽的原因。方法对我院1988年5月-2005年10月收治的9例下肢严重开放伤并发气性坏疽患者的治疗情况进行回顾性总结,分析并发气性坏疽的原因,并对有关问题进行探讨,提出我们的看法和建议。结果9例患者均急诊行大腿中1/3或中上1/3截肢术,术后3-5小时体温开始逐渐下降,12-24小时体温降至38℃左右,3-5天体温恢复正常或接近正常,5-7天肝肾功能恢复基本正常,术后2-3周再次清创,创面植皮或直接缝合,4-6周出院,无死亡病例。结论外伤清创不彻底、治疗不规范是并发气性坏疽的直接原因。Objective Analyze the cause for gas gangrene complicating severe open leg injury. Methods Retrospectively analyzed the cause for 9 cases of gas gangrene complicating severe open leg injury from March, 1988 to Oct, 2005 and provided with our suggestion for effective treatment. Results Amputation surgery was applied to all the 9 cases at 1/3 site of their middle or upper thighs in emergency. Their body temperature decreased after 5 hours of operation, and became normal after 3-5 days. The function of kidney and liver recovered 5-7 days after operation. We performed debridement, dermatoplasty and sutura for the second time 2-3 weeks after surgery. Patients were out of hospital 4-6 weeks after operation. All cases were alive during our treatment. Conclusion Two causes lead to gas gangrene complicating severe open leg injury, which one is incomplete debridement and the other is nonstandard cure.

关 键 词：下肢开放伤 外科清创 气性坏疽 

分 类 号：R633.2[医药卫生—外科学]