上肢高位撕脱离断伤的围手术期注意事项

目的探讨上肢高位撕脱离断伤的围手术期处理方法。方法回顾性分析2006年6月～2010年10月我院收治的5例上肢高位撕脱离断病例的手术处理情况及术后恢复情况。其中肩胛带离断伤3例,肱骨外科颈处撕脱离断2例。结果 1例肩胛带离断伤患者死亡;剩余4例中1例肩胛带离断伤患者行肩部残端修整,另1例肩胛带离断和2例肱骨外科颈处离断伤患者均行断肢再植术。术后平均随访18（10～27）个月,肢体不同程度获得功能恢复。结论上肢高位撕脱离断伤的病人应严格把握手术适应证,在保全生命的前提下采取再植手术,再植成功后的综合治疗使患肢功能得到更好的恢复。

Perioperative Considerations about the Complete Avulsion Injury at the Upper Limbs

Objective To analyze the better perioperative treatments for the complete avulsion injuries at the upper limbs.Methods From June 2006 to October 2010,5 cases of complete avulsion injuries at the upper limbs were treated.Results 1 case died,and 4 cases were followed up for an average of 18(10～27)months.According to the clinical assessment,all the operated limbs got functional recovery in varying degrees. Conclusions It must be strictly defined of the operation indication about the complete avulsion injuries at upper limbs.The replantation must be done under the premise of life preservation.The comprehensive treatments are useful to the recovery of limb function after the successful replantation.