汶川地震骨科伤员伤情分析

目的 探讨地震骨科伤员伤情特点.方法 对2008年5月12日至2008年6月15日收治的1410例汶川地震骨科伤员的基本情况和总体救治情况进行回顾性分析.结果 1410例骨科伤员平均年龄48岁.受伤类别分别为钝器伤(744例,52.7%)、挤压/掩埋伤(379例,26.9%)、跌倒/坠落伤(287例,20.4%);骨折伤员1317例,单纯四肢软组织损伤者93例;261例伤员伴有其他伤病,其中截瘫伤员45例;挤压综合征伤员66例、气性坏疽伤员25例、急性肾功能衰竭伤员76例、多器官功能哀竭伤员26例.共施手术912例次,其中骨折固定术402例,扩创术224例次,清创缝合术152例次,截肢术85例,植皮术29例次,关节脱位手法复位术8例次,皮瓣转移术5例次,神经肌腱修复术4例次,关节镜手术2例次,人工关节置换术1例.66例挤压综合征伤员中,有49例接受持续肾脏替代治疗,其中出现创面知名动脉大出血9例次,进行主干血管栓塞治疗20支.1410例骨科伤员中,因多器官功能衰竭死亡1例.结论 老年伤员较多、伴发伤病多、开放性骨折伤口污染严重、挤压综合征伤员创而处理难度大、截瘫伤员较少、截肢伤员较多,是汶川地震骨科伤员的伤情特点.

Analysis of patients with bone injury in Wenchuan earthquake

Objective To evaluate the patients with bone injury in Wenehuan earthquake.Methods From May 12th to June 15th 2008 the data of 1410 patients with bone injury in Wenchuan earthquake were analyzed to evaluate clinical intervention and remedy-managing experience.Results The 1410 patients average age was from 4 to 103 years old. And 744 cases (52.7% ) suffered from blunt injuries, 379 cases (26.9%) from buried injuries, 287 cases (20.4%) from failing injuries;And 1317 cases were with fracture, 93 with limbs soft tissue injuries;261 patients combined with other parts of injuries including 45 cases with paralysis;66 cases were with crush syndrome, 25 with gas gangrene, 76 with acute kidney failure, 26 with multiple organ failure. And 912 operations were performed including 402 fracture fixation, 224 debridement, 152 debridement and suture, 85 amputation, 29 implant skin, 8 fixation of joint dislocation, 5 surgical flaps transplantation, 4 nerve and tendon suture, 2 arthroscopes, 1 joint replacement.Among the 66 crush syndrome patients, 49 accepted continuous renal replacement therapy, in which 9 cases were bleeding from named arteries and 20 blood vessels were getting embolism.Among the 1410 cases, 1 died from multiple organ failure. Conclusions Among the patients with bone injury in Wenchuan earthquake, the elderly patients are more than the youth;The injuries are always combined with other complications;Opened injuries are polluted severely;It is difficult to deal with the crush syndrome;Paraplegia cases are less, but the amputees are more.