铡草机致复杂手外伤的治疗经验与疗效分析  

Treatment experience and effect analysis of complicated hand trauma caused by crop cutter

作　　者：张岱捷 邓志洋 张政[1] 赵伟[1] ZHANG Daijie;DENG Zhiyang;ZHANG Zheng(Department of Hand Microsurgery,Binzhou Medical University Hospital,Binzhou,shandong,256600,China)

机构地区：[1]滨州医学院附属医院手(显微)外科,山东滨州256600

出　　处：《实用手外科杂志》2023年第3期337-340,344,共5页Journal of Practical Hand Surgery

摘　　要：目的探讨铡草机致复杂手外伤的治疗经验、手术时机与预后。方法回顾性分析2019年6月-2022年6月收治的6例此类患者病例资料,根据其组织损伤、缺损程度及伤口创面愈合情况,采取合适的控制感染、清理创面、修复重建组织等治疗措施。结果术后出现感染4例,经综合治疗伤口稳定后,进行有效的软组织修复重建,最终上肢功能评价:良4例,差2例。结论铡草机所致复杂手外伤综合治疗需要经历多次手术,包括尽早急症清创、及时扩大清创、适时修复组织、功能重建等过程,配合敏感抗生素抗感染治疗,才能达到相对满意的治疗效果。但由于此类患者伤情过于复杂,易合并感染,随访预后手的整体功能恢复欠佳。Objective To explore the treatment experience,surgical opportunity and prognosis of complicated hand trauma caused by crop cutter.Methods By retrospective analysis,a total of 6 such cases were followed up from June 2019 to June 2022.According to their tissue damage,defect degree and wound healing,appropriate treatment measures such as infection control,wound cleaning,tissue repair and reconstruction were taken.Results Postoperative infection occurred in 4 cases.After comprehensive treatment,the wound was stable,and effective soft tissue repair and reconstruction were carried out.The final evaluation of upper limb function:good in 4 cases,poor in 2 cases.Conclusion The comprehensive treatment of complex hand trauma caused by crop cutter requires multiple operations,including emergency debridement as soon as possible,timely expansion of debridement,timely repair of tissue,and final reconstruction of function.Only in combination with sensitive antibiotic anti infection treatment can we achieve a relatively satisfactory treatment outcome.Even so,the overall function recovery of these patients is poor after follow-up due to the complex injury and easy to coinfection.

关 键 词：复杂手外伤 铡草机 感染 

分 类 号：R658.2[医药卫生—外科学]