论文部分内容阅读
目的探讨海水浸泡女性会阴部严重开放性损伤的临床特点,观察综合治疗的效果。方法 31例海水浸泡女性会阴部严重开放性损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、腹腔、盆腔、脏器的反复冲洗,抗休克、多发伤的手术、早期纠正高渗透压、高钠血症、高氯血症、纠正酸中毒、抗感染、复温。观察伤口感染情况、临床治疗结果。结果 31例伤员中,伤口感染率为29%,全身感染率为16%;格拉斯哥预后评分(Glasgow outcome scale,GOS)优良率52%,中度昏迷率16%,重度昏迷率13%,死亡率19%。结论海水浸泡女性会阴部严重开放性损伤临床主要特点是伤因多、创伤机制复杂、严重的多发伤、感染重、海水浸泡伤临床表现突出,海水浸泡所致伤口周围组织与重要器官严重的继发性损伤,全身感染率高且预后差。釆用综合治疗法可提高海水浸泡女性会阴部严重开放性损伤的疗效。
Objective To investigate the clinical features of severe open injury of perineum in seawater immersion women and observe the effect of comprehensive treatment. Methods 31 cases of sea water soaked female perineum severe open wounds were treated with seawater immersion injury comprehensive treatment, including early use of fresh water or saline on the wound, abdominal cavity, pelvic organs repeatedly washed anti-shock, multiple trauma surgery, early Correct the high osmotic pressure, hypernatremia, hyperchloremia, correct acidosis, anti-infection, rewarming. Observe wound infection, clinical treatment results. Results The wound infection rate was 29% and the systemic infection rate was 16% in 31 cases. The excellent and good rate of Glasgow outcome scale (GOS) was 52%, moderate coma was 16%, severe coma was 13% and mortality was 19%. Conclusions The main clinical features of severe open injury of perineum in seawater immersed women are multiple injuries, complicated trauma mechanism, severe multiple trauma, severe infection and immersion in seawater. The clinical manifestations of severe wound damage in seawater immersion are serious. Hair damage, high systemic infection rate and poor prognosis. Preclude the use of comprehensive treatment can improve sea water soaked perineum severe open injury curative effect.