多发性骨与关节损伤病例回顾分析

目的：研究多发性骨与关节损伤的流行病学特点，探讨多发性骨与关节损伤的诊治经验教训。方法：对本院2000年1月1日～2004年1月1日间的318例多发性骨与关节损伤病例进行回顾分析，并进行随访。结果：符合诊断标准的多发性骨与关节损伤病例占304医院骨科创伤病区住院患者总数的16．39％，高发年龄为20～40岁之间，占总病例数的59．43％．患者中男性明显多于女性．致伤原因最多为道路交通伤，最常见损伤部位为胫腓骨干，最常见的并发症为失血性休克．治疗以早期固定及早期功能康复为好?结论：重视多发性骨与关节损伤的院前急救，强化对门诊及急诊医护人员的培训．可以提高多发性骨与关节损伤诊断的准确率，降低漏诊率，提高救治的成功率并降低死亡率。早期合理的固定是多发性骨与关节损伤的最佳治疗措施，加强早期合理的主被动综合性功能锻炼．可以明显提高患者的功能康复水平。

Multiple injuries of bone and joint: a review of 318 cases

Objective:The epidemic characteristics of multiple injuries of bone and joint(MIBJ) were investigated,and relevant experiences and lessons from the prevention and treatment of this injury were analyzed.Method:A total of 318 cases of MIBJ from 2000 to 2004 were reviewed retrospectively,among which 272 cases were followed up for an averaged 23.6 months( ranging from 12 months to 45 months).Result:A total of 16.39% of all the inpatients in the Trauma&Orthopaedic Department of the 304th Hospital have met the diagnostic requirement of MIBJ.From the result of the investigation,the most commonly seen reason for the injuries was the traffic accident,the most commonly injured part was the shaft of tibia and fibula,and the most commonly seen complication was hemorrhagic shock.The patients who were given operative treatment within 72 hours after the injury had better recovery effects than those who were treated with delayed surgeries.Conclusion:Receiving first-aid to the injury and proper training of the medical workers are key factors of raising the accuracy of diagnosis and decreasing the death rate.Early stage fixation to the injured part and postoperative rehabilitation can significantly improve the recovery effect .