开放性骨盆骨折软组织损伤的处置策略  

Management strategies for the soft tissue injury of open pelvic fractures

作　　者：李阳 张连阳 Li Yang;Zhang Lianyang(State Key Laboratory of Trauma,Burns and Combined Injury,Center of Trauma and War Injury,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院战创伤医学中心,创伤、烧伤与复合伤国家重点实验室,重庆400042

出　　处：《创伤外科杂志》2021年第6期401-405,共5页Journal of Traumatic Surgery

基　　金：陆军军医大学临床技术创新培育项目(CX2019JS109)。

摘　　要：开放性骨盆骨折常合并严重软组织损伤,处置棘手、并发症多、病死率高。近年来,随着损害控制理念和软组织重建技术的发展进步,开放性骨盆骨折合并严重软组织损伤的并发症发生率及早期病死率显著降低。本文从损伤评估、早期处理、感染控制和软组织修复重建方面阐述开放性骨盆骨折软组织损伤的处置策略,提出早期准确的软组织损伤评估分型、及时合理的结肠造口和膀胱造瘘、稳健的清创节奏把握、有的放矢的抗生素使用和感染控制,以及精细的创面修复技术运用是开放性骨盆骨折软组织损伤成功治疗的关键。Open pelvic fracture is often accompanied by severe soft tissue injury,which is difficult to handle,and often with multiple complications and high mortality.In recent years,with the increasing popularity of the concept of damage control and the development of soft tissue reconstruction techniques,the early mortality rate and complication rate of open pelvic fractures with severe soft tissue injury have been significantly reduced.This paper discusses the management strategy of soft tissue injury of open pelvic fracture from the aspects of soft tissue injury assessment,early management,infection control and soft tissue repair and reconstruction.It is suggested that early and accurate classification of soft tissue injury assessment,timely and rational colostomy and cystostomy,steady control of debridement rhythm,targeted antibiotic use and infection control,and delicate application of wound repair technology are the keys to successful treatment of soft tissue injury in open pelvic fracture.

关 键 词：软组织损伤 开放性骨盆骨折 评估 感染 创面修复 

分 类 号：R683.3[医药卫生—骨科学]