寒冷干燥地区平时火器伤的早期处理

目的　探讨寒冷干燥地区平时火器伤伤情特点与早期救治方法。方法　对 1991年 1月— 2 0 0 2年 12月间 40例火器伤病人的临床救治进行回顾分析。结果　 2 4例枪伤中 ,2 0例一期缝合伤口 ,均一期愈合 ,另外 4例只清创未一期缝合的伤口 ,3例愈合 ,1例感染 ;4例骨折内固定均愈合良好 ,无骨髓炎发生。 16例炸伤病人局部软组织损伤及污染比枪弹伤重 ,14例一期缝合伤口中 ,10例一期愈合 ,4例感染 ,骨折内固定 2例 ,均愈合良好 ,无骨髓炎发生。结论　寒冷干燥地区火器伤早期伤道清创时限可适当延长 ,在平时火器伤的救治中 ,对软组织条件较好的创面 ,早期清创后可一期闭合伤口和骨折内固定 ,这样可减少感染和伤残 ,促进康复

Early Treatment of Firearm Wound in Peacetime in Cold and Dry Region

Objective The article study characteristic and early treatment firearm wound in peacetime in cold and dry region. Methods Clinical management data of 40 cases of firearm wound from Jan. 1991 to Dec.2002 were analysed by means of wounding tract and fracture.Results During 24 cases of gunshot wound, wounds of 20 cases healed without event after primary debridment and sewing wounds,3 cases healed and l case infected in 4 cases of primary debridment without suture,and 4 cases of primary internal fixed fracture had no osteomyelitis.The injury of soft tissue and contamination of wound track were serious in explosion wound than in gunshot wound,10 cases healed without event and 4 cased infected in l4 cases of primary closed explosion wounds,and 2 cases of primary inernal fixed fracture had no osteomyelitis.Conclusion It is suggested that the management of firearm wound in cold and dry region may be delayed moderately in time of debridement.The firearm wound may be treated by internal fixation of fracture and primary closing of tract after early debridment when the soft tissue injury was light in peacetime, which decreased the infection,disability and promoted rehabilitation of patients.