犬咬伤致开放性骨折的急诊处理研究  

Study： emergency treatment to open fracture of dog bite wounds

作　　者：陈瑞丰[1] 王立秋[1] 黄立嵩[1] 郑吉波[1] 

机构地区：[1]中国人民解放军海军总医院急诊科,北京100048

出　　处：《中国急救复苏与灾害医学杂志》2012年第10期913-915,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨犬咬伤导致的开放性骨折的急诊处理方法。方法选取300例犬咬伤致开放性骨折患者，随机分为对照组（A）和实验组（B），A组骨折采用I期（急诊）手术、内固定；B组采用骨折Ⅱ期（延期）治疗方式。分别观察其感染率、骨髓炎、延期愈合率及创份陛关节炎发生率。结果A组较B组感染率、骨髓炎、延期愈合率高（P〈0．05），在创伤性关节炎发生率上无统计学差异（P〉0．05）。结论犬咬伤所致的开放性骨折清创时应对创口内进行长时间清洗和消毒，清创后骨折应采取Ⅱ期（延期）治疗。Objective To investigate the emergency treatment to open fracture of dog bite wounds. Methods 300 cases of open fracture attacked by dog were randomly divided into two groups with each group of 150, the control group （group A） and the experiment group （group B）. All the lacerations were given thoroughly debridement. After the debridement, group A was treated by normal procedure with emergency internal fixation, while group B was fixed by plaster slab, and enforced postpone operation 5-7 days. The rate of infection, osteomyelitis, delayed union, and traumatic arthritis were analyzed. Results Between group A and group B, the infection rate was 12.0% and 4.7% （P〈0.05）; the rate of osteomyelitis was 6% and 1.3% （P〈0.05）; and the rate of delayed union was 8% and 2.7% （P〈0.05）; the rate of traumatic arthritis was 6.7% and 8% respectively （P〉0.05）. Conclusion In the procedure of debridement of open fracture after dog bites, a longer and thorough cleaning and disinfection to the internal wounds is considered necessary followed by the fixed postpone after debridement 5-7 days.

关 键 词：犬咬伤 开放性骨折 清创术 固定术 

分 类 号：R646[医药卫生—外科学]