儿童手部爆炸伤的分类与治疗策略
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作者Author单位AddressE-Mail
王兵 WANG Bing 上海交通大学附属第六人民医院骨科,上海200233 Department of Orthopedics,the 6th People′s Hospital of Shanghai Affiliated to Jiaotong University,Shanghai,200233 China kangqinglin@hotmail. com 
康庆林 KANG Qing-lin 上海交通大学附属第六人民医院骨科,上海200233 Department of Orthopedics,the 6th People′s Hospital of Shanghai Affiliated to Jiaotong University,Shanghai,200233 China  
期刊信息:《中国骨伤》2007年,第20卷,第9期,第599-600页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:总结小儿手部爆炸伤的损伤特点,探讨其诊治方法。

方法:对1994-2006年收治的108例小儿手部爆炸伤伤情和治疗过程进行回顾性分析,男91例,女17例;年龄3~12岁,平均6.7岁。根据损伤特点分为3种类型:撕裂伤58例,离断伤35例和毁损伤15例。撕裂伤清创后予以原位缝合,离断伤清创后急诊再植,毁损伤清创后采取Ⅰ期修复或截肢(共5例)和延期修复(10例)2种方式。

结果:58例撕裂伤伤口Ⅰ期愈合,35例离断伤中28例再植成活,15例毁损伤中10例经延期修复者术后感染机会明显降低。随访5个月~4年,撕裂伤组功能恢复最好,离断伤组功能恢复次于撕裂伤组,毁损伤组功能恢复最差。

结论:小儿手部爆炸伤严重妨碍其肉体生长和心理发育,采取相应的防范措施,能有效预防此类损伤发生。
【关键词】  创伤和损伤  外科手术  修补手术,外科  儿童
 
Classification and treatment of hand explosive injury in children
ABSTRACT  

Objective:To retrospectively analysis the characteristic of hand explosive injuries in children,and explore the methods of treatment.

Methods:From 1994 to 2006,108 patients(male 91 and female 17,ranging in age from 3 to 12 years,with an average of 6.7 years)with hand explosive injury were reviewed.According to the injury characteristics,the hand explosive injuries were classified into three types:58 cases of laceration injury,35 cases of mutilation injury and 15 cases of smashed injury.The laceration injuries were primarily sutured after debridement,the mutilation injuries were replanted after debridement,5 patients with the smashed injury were repaired primarily or amputed,the other 10 patients with smashed injury were other delayed repaired.

Results:For 58 patients with laceration injury,the wound healed primarily.Among 35 patients with mutilation injury,28 patients were successfully replanted.After delayed repair,the infection rate in 10 patients with smashed injury decreased significantly.The duration of follow-up ranged from 5 months to 4 years.The recovery of function in the hand of the patients with laceration injury was the hest,the mutilation injury was good.The recovery of function of smashed hands was the worst among three types.

Conclusion:The hand explosive injury affacts not only the physical health but also the psychological development of children.The prevention efforts toward public education and legislative reforms may help to prevent these unnecessary injuries.
KEY WORDS  Hand  Wounds and injuries  Surgical procedures,operative  Revision,surgical  Child
 
引用本文,请按以下格式著录参考文献:
中文格式:王兵,康庆林.儿童手部爆炸伤的分类与治疗策略[J].中国骨伤,2007,20(9):599~600
英文格式:WANG Bing,KANG Qing-lin.Classification and treatment of hand explosive injury in children[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(9):599~600
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