手部高压注射伤的损伤机制与治疗进展  

Injury Mechanism and Treatment Progress of High-Pressure Injection Injuries of Hands

作　　者：穆钛飞 王成 陈世玖 MU Taifei;WANG Cheng;CHEN Shijiu(Department of Plastic and Hand Surgery,the Fifth Affiliated(Zhuhai)Hospital of Zunyi Medical University,Zhuhai 519100,China)

机构地区：[1]遵义医科大学第五附属(珠海)医院整形手外科,广东珠海519100

出　　处：《医学综述》2021年第8期1585-1590,共6页Medical Recapitulate

基　　金：广东省医学科学技术研究基金(20181020181016427)。

摘　　要：随着工业化进程的发展,高压喷枪已广泛应用于人们的生活及工作中,手部高压注射伤(HPIIH)患者也随之增多。由于HPIIH早期疼痛不明显且伤口小,患者容易忽视,导致医师易漏诊、误诊。随着病情迅速发展,HPIIH可导致患者截指的严重后果。其治疗遵循尽早切开减压、重复彻底清创、开放引流、二期缝合、术后早期功能锻炼的原则。虽然显微外科、负压封闭引流技术以及皮瓣移植技术已日趋成熟,但截指率仍较高。目前关于HPIIH的诊治尚无统一指南,学者们对早期清创的定义以及糖皮质激素的应用也均存在争议。未来可从动物实验中收集HPIIH后的炎症指标,并在应用糖皮质激素治疗后对动物的炎症反应进行评价,从而为临床HPIIH患者的治疗提供依据,降低截肢(指)率。Along with the industrialization and development,high pressure spray gun is widely applied in people’s life and work,and the number of patients with high-pressure injection injuries of hands(HPIIH)has also increased.Because the early pain is not obvious as well as the wound is small,the patients may overlook easily,which may result in misdiagnosis and missed diagnosis.With the rapid development of the disease,it can cause serious results of amputation.The treatments should follow the principles of incision decompression as soon as possible,repeated thorough debridement,open drainage,secondary suture,and early postoperative functional exercise.Although microsurgical,vacuum sealing drainage,and skin flap transplantation technology are mature,the amputation rate is still high.There is no unified clinical guidelines about the diagnosis and treatment of HPIIH so far,and different scholars have different ideas about the definition of early debridement and the application of glucocorticoid.In the future,the inflammatory indexes after HPIIH can be collected from animal experiments,and the inflammatory reaction of animals can be evaluated after glucocorticoid treatment,so as to provide the basis for the clinical treatment of HPIIH patients and reduce the rate of amputation.

关 键 词：高压注射伤 手 清创 截指 

分 类 号：R658.2[医药卫生—外科学]