急诊综合修复电损伤临床回顾分析  

Retrospective clinical analysis of the emergent comprehensive repair of electrical injury

作　　者：朱志祥[1] 许晓光[1] 李伟萍[1] 李华强[1] 徐旭[1] 刘天一[1] 鲁延龄 

机构地区：[1]深圳市红十字会医院烧伤整形科,518035

出　　处：《中华烧伤杂志》2001年第1期18-21,共4页Chinese Journal of Burns

基　　金：国家卫生部立项课题!(188-270);广东省医学科研基金资助项目!(A-1999547)

摘　　要：目的 回顾分析急诊综合修复电损伤的临床应用。 方法 依据病历和照片资料，对14年间155例电损伤患者急诊修复进行综合分析。 结果 该组病例伤后到入院的平均时间是(14.09±21.5)h ，其中108例（70%）在伤后2 h内入院；入院到首次手术时间平均为(3.74±9.89)h（70%的患者为入院后1 h内）。459个部位清创后共保留裸露、失活或坏死的肌腱296条、血管19条、骨或关节196条或块、神经16条。首次修复中移植肌腱、骨、神经和血管等24例次。459个部位共使用组织瓣398块；全部皮瓣下连续CLS(等渗盐水1 000 ml，利多卡因1 g，氯霉素1 g)冲洗24～96 h 或更长；全部病例常规应用复方丹参注射液；结果功能外形优良率占84.9%，差和截肢（指）占9.6%。［截肢（指）率是1.8%］。如果包括伤后自然丧失的肢体，总肢体丧失率是9%。 结论 急诊综合修复电损伤是一有效降低肢体丧失率的可行方法。Objective To summarize the experience with clinical emergent comprehensive repair of electrical injury. Methods One hundred fifty five cases of electrical injury during past 14 years were analyzed in terms of the emergent repair methods on the basis of medical records and photographs . Results In this group of patients the average interval between injury and hospitalization was 14.9±21.5 hours,And 108 cases(70%)were admitted to hospital within 2 hours post injury.The average time between admission and first operation was 3.74±9.89 hours,and 70% of them was within 1 hour after admission.Four hundred and fifty nine wounds were debrided and 296 strips of tendons,19 strips of blood vessels,196 pieces of bone or joints and 16 strips of nerves,which were exposed,devitalized or necrotic,were saved.The grafting repair of tendons,bones,nerves and blood vessels was done in 24 case times.Three hundred and ninty eight tissue flaps were employed in 459 wounds.CLS(NS+Lidocaine+amphicol) solution was employed to irrigate underneath the flaps for 24～96 hours or longer.Composite dan-shen root (scatellaria indica)solution was given to all the patients by injection.As a result,the excellent rate of function and contour was 84.8%.The unsatisfactory and amputation rate was 9.6%.The rate of extremity and/or finer amputation was 1.8%.The rate of total limb loss including those lost instantly after injury was 9%. Conclusion Emergent comprehensive management of electrical injury was a feasible and effective method for decreasing extremity loss.

关 键 词：急诊 修复 电损伤 手术治疗 

分 类 号：R647[医药卫生—外科学]