The Cause and Therapy of Open Fracture on Earthquake in Wenchuan_West China Medical Journal

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West China Hospital,Sichuan University,Chengdu Sichuan 610041,China;

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Keywords：

地震; 开放性骨折; 治疗方法; 汶川

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目的:探讨汶川地震伤中开放性骨折原因分析及治疗策略。方法:回顾性分析280例汶川地震中开放性骨折患者病例,总结骨折原因及治疗方法。结果:患者压砸伤266例,占95%,其他受伤方式约占5%。治疗上急诊行内固定手术者88例,占31%,行外支架固定者69例,占24%,单纯石膏外固定者60例,占21%,截肢患者63例,占22%,63例截肢患者中40例为肢端缺血坏死引起,占14%,15例为肢体毁损引起,占5%,8例为气性坏疽引起,占2%。结论:汶川地震伤中开放性骨折原因多为压砸伤,治疗首先考虑全身治疗,抢救生命,骨折治疗根据Gustilo分度及肢体有无气性坏疽或坏死而进行相应的治疗。又因为地震伤有受伤人群多,受伤时间长,感染严重及救治困难等特点,故应根据病情采取相应的特殊救治方法。

Citation： RAN Bo,SONG Yueming,LIU Hao,et al.. The Cause and Therapy of Open Fracture on Earthquake in Wenchuan. West China Medical Journal, 2009, 24(10): 2522-2525. doi: Copy

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9.	冯国勋. 地震灾害所致创伤后感染的治疗体会. 空军总医院学报,2008, 24 (3): 165, 167.
10.	BAKER SP, O NEILL B, HADDON W, et al. The injury severity score: amethod for describing patients with multiple injuries and evaluatingemergency care. J Trauma,1974,14:187-196.
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1. TAHMASEBI M N, KIANIK, MAZLOUMAN S J, et al. Musculoskeletal injuries associated with earthquake a report of injuriesof Iran ’s December 26, 2003 Bam earthquake casualties managed in tertiary referral centers[J]. Injury, 2005, 36(1): 27-32.
2. ROY N, SHAH H, PATEL V, et al. Surgical and psychosocialoutcomes in the rural injured: a followup study of the 2001 earthquake victims[J]. Injury, 2005, 36(8): 927-934 [3]S.Terry Canale主编,卢世璧,王继芳主译.坎贝尔骨科手术学.第9版.济南:山东科学技术出版社,2001,2:2323-2330.
3. 张英泽,孔志刚,王锡民,等.张北地震灾区骨科伤员救治经验与教训[J].中国骨伤, 2000, 13(7):400.
4. 王明新,汪茜,匡正达,等.印尼日惹地震救援中骨折患者手术治疗的研究和探讨[J].武警医学, 2006, 17(10): 790-791.
5. 刘大雄.开放性骨折内固定治疗中的几个问题.骨与关节损伤杂志,2003,18(3):145.
6. 朱通伯. 处理开放性骨折及关节创伤的新观点. 中华骨科杂志, 骨科教程1, 1996, 241.
7. 蒲丹, 乔甫, 张卫东, 等. 67例疑似气性坏疽地震伤员院内交叉感染控制分析. 中国循证医学杂志, 2008, 8(8): 620-622.
8. 王正国.灾害和事故的创伤救治[M].北京:人民卫生出版社, 2005,336.
9. 冯国勋. 地震灾害所致创伤后感染的治疗体会. 空军总医院学报,2008, 24 (3): 165, 167.
10. BAKER SP, O NEILL B, HADDON W, et al. The injury severity score: amethod for describing patients with multiple injuries and evaluatingemergency care. J Trauma,1974,14:187-196.
11. 史占彪,张建新．心理咨询师在危机于预中的作用．心理科学进展,2003,31(4):393-399．.

West China Medical Journal

The Cause and Therapy of Open Fracture on Earthquake in Wenchuan

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