手掌部油漆高压注射伤的治疗  

Treatment of high-pressure paint injection injury in the palm of the hand

作　　者：符祖昶 周晓文 黄飞[1] 赵枫[1] 艾建国[1] FU Zuchang;ZHOU Xiaowen;HUANG Fei(Department of Orthopaedics,No.910 Hospital of Joint Logistics Support Force of Chinese PLA,Quanzhou,Fujian,362000,China)

机构地区：[1]中国人民解放军联勤保障部队第910医院骨科,福建泉州362000

出　　处：《实用手外科杂志》2023年第3期370-374,共5页Journal of Practical Hand Surgery

摘　　要：目的总结手部高压注射伤的临床治疗原则、相关解剖及治疗效果等,以进一步完善本病的治疗策略。方法回顾性收集2015年1月-2021年7月收治的11例手掌部高压注射伤患者的临床资料,分析手术疗效并总结相关临床经验。结果11例均获得至少3个月的随访,其中8例二期扩大清创后直接闭合切口,3例经过3次清创后闭合切口,无软组织缺损行皮瓣修补的患者。指功能按手指总主动活动度(TAM)标准评定:优10例,良1例。3例注射物通过虎口区通往掌背侧,术后1个月随访,拇指功能与健侧无明显区别,虎口区皮肤无异常。结论手掌部油漆高压注射伤在早期彻底清除潜在间隙的注射物,二期再次扩大清创,术后早期功能训练可获得满意疗效。Objective To review and summarize the efficacy of hand hyperbaric injection injuries and describe their treatment principles and related anatomy,etc.to further improve related treatment strategies.Methods The clinical data of 11 patients with high pressure injection injuries to the palm of the hand admitted to our hospital from January 2015 to July 2021 were retrospectively collected to analyze the surgical efficacy and summarize relevant clinical experiences.Results All 11 patients received at least 3 months of follow-up.Eight of these patients had direct closure of the incision after second-stage extended debridement,and three had closure of the incision after three debridements,without soft tissue defects for flap repair.Finger function was rated as excellent in 10 cases and good in 1 case according to the total active finger mobility(TAM)criteria.In three cases,the injected material passed through the first web to the dorsal side of the palm,and the thumb function was not significantly different from that of the healthy side and the skin of the first web was not abnormal at the 1 month postoperative follow-up.Conclution Paint high-pressure injection injuries to the palm of the hand can be satisfactorily treated under early and complete removal of the potential interstitial injections,second-stage re-expansion of the debridement,and early postoperative functional exercise.

关 键 词：高压注射伤 手掌 显微外科 解剖 

分 类 号：R658.2[医药卫生—外科学]