颅脑外伤昏迷者的骨折治疗时机选择  

The Best Time of Operation for Fracture Patient with Craniocerebral Trauma Coma

作　　者：王毅平[1] 

机构地区：[1]广东省深圳市罗湖区人民医院,518001

出　　处：《医学理论与实践》2002年第4期401-402,共2页The Journal of Medical Theory and Practice

摘　　要：目的:骨折合并重症颅脑外伤昏迷是在临床上较为常见。研究骨折治疗时机尤其重要。方法:通过一组临床病例,以四肢骨折为主,需急诊脑外手术,没有严重的其它脏器损伤者61例,按不同情况分为3组,分别选择不同的骨折治疗时机,1组的骨折手术与脑外科急诊手术同时进行,2组在伤后5～10d内进行,3组则在伤后14～45d进行。结果:本组61例中,43例随访时间超过1年。检测肢体功能恢复状况,接近正常者1组、2组、3组分别占91.3％、88.2％、62.8％。结论:早期手术治疗骨折,复位及固定容易,解剖复位率高,耗时短,创伤小,病人痛苦少,且可避免长时间肢体外固定,便于早期功能锻炼,促进全身恢复。尽早行切开复位内固定也有利于脑外伤的救治。Objective:To probe into the best time of operation for fracture patients with craniocerebral trauma coma.Methods:61 cases with fracture patients combined with craniocerebral trauma coma were divided into 3 groups, and the operation cure time for fracture patients of the 3 groups were chosen differently: for group 1, the emergency operation of the fractured bones was carried out at that time of the craniocerebral emergency surgery; for group 2, the operation was carried out in 5 ~ 10 days after craniocerebral trauma, and for group 3,in 14-45 days after the trauma.Results:43 cases from the 61 patients were followed up for a year,and it was showed that in the 3 groups 91.3%,88.2% and 62.8 % of patients were respectively recovered to be close to normal in function of four limbs. Conclusion: The earlier the broken bones is replaced and fixed, the more rate of anatomical replacement is, and the less the patients suffer from the wounds. It can also avoid long-term external fixation, and make early function exercise possible for the wounded, so that promote recovery of the body. To carry out section, replacement and internal fixation as early as possible can be helpful in treatment of craniocerebral trauma.

关 键 词：颅脑外伤 骨折 手术时机 

分 类 号：R651.15[医药卫生—外科学] R683[医药卫生—临床医学]