高原性脑水肿并发骶尾部压力性损伤创面修复1例  

A case of plateau cerebral edema complicated by pressure injury repair of the sacrococcygeal region

作　　者：文劲松 胡逸萍 李罡 黄峻 李孝建 张志 WEN Jinsong;HU Yiping;LI Gang;HUANG Jun;LI Xiaojian;ZHANG Zhi(School of Clinical Medicine,Guizhou Medical University,Guiyang,Guizhou 550004,China;Department of Burns and Plastic Surgery,Guangzhou Red Cross Hospital,Guangzhou,Guangdong 510220,China)

机构地区：[1]贵州医科大学临床医学院,贵州贵阳550004 [2]广州市红十字会医院烧伤整形科,广东广州510220

出　　处：《安徽医药》2024年第11期2288-2290,I0010,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨高原性脑水肿(HACE)并发骶尾部压力性损伤治疗经验。方法总结广州市红十字会烧伤整形科2020年9月收治的1例高原性脑水肿并发骶尾部压力性损伤病人的治疗方案。结果经3次清创封闭式负压吸引治疗后(入院后第21天),骶尾部创面为11.0 cm×7.5 cm×3.0 cm且深达骨质。术中清除坏死组织,分离健康臀大肌组织与棘上韧带缝合,设计双叶瓣覆盖创面,术后皮瓣成活良好。于入院第36天,骶尾部创面愈合,髋关节功能及臀部外观良好予以出院。结论年轻体健病人发生高原性脑水肿,在救治原发病的同时也不能忽略压力性损伤的预防,在选择创面修复的方式时应根据创面的形状、大小及结合病人自身条件选择合适的手术修复方式。Objective To explore the treatment experience of plateau cerebral edema complicating sacrococcygeal pressure injury.Methods To summarize the treatment plan of a patient with plateau cerebral edema complicated by sacrococcygeal pressure injury admitted to the burn and plastic surgery department of Guangzhou Red Cross Society in September 2020.Results After three times of closed negative pressure suction treatment(day 21 after admission),the sacrococcygeal wound was 11.0 cm×7.5 cm×3.0 cm and deep to the bone,necrotic tissue was removed,healthy gluteus maximus tissue was separated and sutured to the supraspinatus ligament,and a double leaf flap was designed to cover the wound,and the flap survived well after surgery.On the 36th day of admission,the sacrococcygeal wound healed,and the hip joint function and hip appearance were good,and the patient was discharged from the hospital.Conclusion When plateau cerebral edema occurs in young and fit patients,the prevention of pressure injury should not be neglected while treating the primary disease,and the appropriate surgical repair method should be selected according to the shape and size of the trauma and the patient's own conditions.

关 键 词：高原病 脑水肿 压力性损伤 创面修复 

分 类 号：R594.3[医药卫生—内科学] R687[医药卫生—临床医学]