【摘要】 目的总结建筑物垮塌所致四肢开放性骨折的救治经验,探讨救治方法。方法回顾性分析31例四肢开放性骨折的救治工作,分析伤口病原学分布及药敏试验结果,比较早期手术组与延期手术组的恢复情况,观察骨折固定及高压氧治疗的疗效。结果 31例(87.1%)细菌培养阳性,革兰氏阴性菌病例占90.3%,绝大多数细菌对三代头孢及哌拉西林舒巴坦敏感。早期手术组伤口甲级愈合率明显高于延期手术组(P=0.011)。外固定支架手术减少了组织损伤。2例植皮手术辅以高压氧治疗皮瓣成活良好,术区无感染。结论建筑物垮塌所致四肢开放性骨折伤情复杂严重,应积极防治疗伤口感染并据伤情分别处理,外固定支架作骨折固定及高压氧辅助治疗能促进愈合。更多还原

【Abstract】 Objective To summarize the treatment experiences of limb open fracture caused by collapse building,and investigate treatment methods.Methods Retrospectively analysed the data of 31 cases of limb open fracture,pathogen distribution of wound and drug susceptibility test results.Made a comparision of recovery between the early surgery group(ESG) and the delayed surgery group(DSG).Observed the effect of the fracture fixation and hyperbaric oxygen therapy(HOT).Results The bacterial culture positive rate was 87.1%,gram-negative bacteria accounted for 90.3% of cases,the vast majority of bacteria was sensitive to the third generation cephalosporins and piperacillin-sulbactam(P = 0.011).External fixation surgery reduced tissue injury.Flaps of two cases undergone skin grafting combined with HOT survived well,without infection in operation area.Conclusion The injury of limb open fracture by collapse building is complex and serious,it is necessary to control wound infection and treat according to injury.External fixation for fracture fixation and hyperbaric oxygen therapy can promote healing.更多还原