四川汶川大地震骨科伤员的早期救治

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1、四川汶川大地震骨科伤员的早期救治作者：朱锦宇,郭征,王臻,闫铭,赵广跃,丛锐,王倩,张瑶,张楠【摘要】[目的]“5.12”四川汶川大地震发生后，本院野战医疗所紧急赶赴极重灾区安县(紧临极重灾区北川县)，1周内作者所在的医疗分队共处理284例骨科伤员，本文初步探讨大地震骨科伤员早期紧急救治的经验和体会。[方法]对284例骨科伤员的救治情况进行回顾、分析。[结果]骨科伤员包括脊柱四肢骨折脱位、手足外伤、周围神经损伤和四肢软组织伤。年龄11～92岁，平均49.3岁。男133例，占46.8%，女151例，占53.2

2、%。骨折脱位伤员188例，其中上肢骨折85例，下肢骨折73例，脊柱骨折23例，肩或髋关节脱位7例。手足外伤、周围神经损伤和四肢软组织伤96例。开放性创伤67例，其余为闭合性创伤。131例经过治疗痊愈出院，其余患者病情稳定后转送至后方医院继续治疗。术后X线复查，21例外固定架术后的患者骨折复位固定满意，肩或髋关节脱位均成功复位，一期缝合患者无伤口感染，也未发现其它手术并发症。[结论]正确判断伤情，采取科学合理的治疗措施，严格把握手术适应证，不做确定性骨折内固定治疗，外固定架固定四肢骨折是地震伤员紧急救治中一个

3、简便有效的治疗方法。【关键词】地震;早期救治;骨科;四川省11　　Abstract：[Objective]OnMay12,2008,anover8.0magnitudeearthquakeoccurredinWenchuancounty,Sichuanprovince,China.Theanthor'sfieldhospitalwasdeployedtoAncounty,whicharrivedonthe3rddayafterthedisaster.Duringthefirstweekofthedeplo

4、yment,284victimswithmusculoskeletalinjuriesreceivedorthopedicmanagement.Theobjectiveofthisarticleistohighlighttheexperiencegainedbythisauthor'smedicalassistanceteam,focusingontheorthopediccareintheearlypartofthepostdisasterreliefactivities.[Method]Records

5、of284patientswhounderwentorthopedicmanagementwerereviewedretrospectively.[Result]Therewerealargenumberofmusculoskeletalinjuriesamongstthesurvivorsintheacutephaseofthedisaster,includingspinaltrauma,fracturesanddislocations,peripheralnerveinjuriesandsofttiss

6、ueinjuries.Theaverageagewas49.3years(range,11to92years)with133menand151women.Thepatientswithupperextremityfracturewere85,withlowerextremityfracture73,withspinalfracture23,withshoulderorhipdislocation7.Thepatientswithhandorfootinjuries,peripheralnerveinjuri

7、esandsofttissueinjurieswere96.Openinjurieswere67,theremainingwereclosed11injuries.Totally131patientsrecovered,andtherestweretransferredtotherearhospitalforfurthermanagement.TheXraypostoperativelyshowedthat21openfractureswerereducedfunctionallybymeansofext

8、ernalfixator,andtheshoulderorhipdislocationswerereducedanatomically.Thewoundswithprimarysuturehadnoinfection.Therewerenoothercomplications.[Conclusion]Correctdiagnsisoftheinjuries,providingscientificandresona