海水浸泡严重开放性颌面部损伤的治疗

目的探讨海水浸泡口腔颌面部创伤的临床特点,观察综合治疗的效果。方法 127例海水浸泡颌面部创伤伤员采用海水浸泡伤综合治疗法,包括早期用淡水或生理盐水对伤口的反复冲洗,抗休克、手术,早期纠正高渗、高钠、高氯血症、酸中毒,抗感染、复温。观察伤口感染情况、临床治疗结果和功能恢复结果。结果 127例伤员中,伤口感染率为3%;格拉斯哥预后评分（Glasgow outcome scale,GOS）评分优良率为86%,死亡率为2%,均死于颅脑伤;12个月功能恢复优良率91%。结论海水浸泡口腔颌面部创伤,临床主要特点是伤口周围组织和主要器官损伤严重,伤口感染率高及预后差,综合治疗法可提高创伤疗效。

Therapy of Severe Open Maxillofacial Trauma with Seawater Immersion

Objective To study the clinical characteristics of severe open maxillofacial trauma with seawater immersion and observe the therapeutic effect of combined treatment.Methods A total of 127 patients with severe open maxillofacial trauma with seawater immersion underwent combined treatment including repeated wash of wounds with freshwater or normal saline,anti-shock,surgery,early correction of electrolyte imbalance and metabolic acidosis,anti-infection,and rewarming.The infection of wounds,clinical treatment and function recovery results were observed.Results In 127 cases,the wound infection rate was 3%,the excellent rate according to the Glasgow outcome scale（GOS） was 86%,the mortality was 2%（being died from brain injuries）,and the excellent rate of function recovery was 91% 12 months after trauma.Conclusion The main clinical characteristics of severe open maxillofacial trauma with seawater immersion include severe injury of tissues around the wounds and important organs,high wound infection rates and bad prognosis.The therapeutic effect can be improved by combined treatment.