摘要
目的 :探讨毁损性烧伤截肢临床分型及意义。方法 :总结分析近 15年收治的 67例 (78肢 )毁损性烧伤截肢病例 ,从循证医学角度对烧伤截肢进行临床分型。结果 :本组发病年龄 3～ 78岁 ,16岁以上成人居多(4 6例 ,68 7% ) ,16岁以下少儿偏少 (2 1例 ,3 1 3 % ) ,男女之比 2 7∶1,致伤原因电烧伤占绝大多数 (5 5例 ,占82 1% ) ,上肢截肢率高达 79 5 % ,截肢临床分型为 :①缺血坏死型 ;②无法修复型 ;③修复后外形差无功能型 ;④“舍肢保命型” ;⑤患者和家属请求型。结论 :①以循证医学理念将毁损性烧伤截肢临床分型 ,可以为临床医生给患者和家属谈话 ,截肢指征的确立 ,截肢术中操作原则和预后判断等提供依据 ,也可为避免或减少无谓的医患纠纷起积极作用。②影响实施截肢因素不仅取决于伤情 ,还与当前医学发展、地区医学水平和假技技术水平、患者和家属对伤情认识及经济花费的承受能力等有关 ,所以同一伤情其处理方法会出现多样化。
Objective: To study the clinical typing and meaning of damaged burned limb amputation.Methods: To sum up and analysis the 67 patients (78 limbs) who had damaged burned limb amputation admitted in our hospital recently 15 years,we make up the clinical typing to burned limb amputation in the angle of evidence based medicine (EBM).Results: The cases's age distributed from 3 to 78 years old.The patients who were over 16 years old were more (46 cases ,68.7 %) than those who were less than 16 years old. The ratio of the male to female was 2.7:1. The electrical injury (55cases,82.1%) is the most in the injury reasons. The limb amputation rate on upper limbs is much more (80.8%). It was classified into 5 types: ①Ischemic necrosis type. ②Unable repaired type . ③The type of no good appearance and no-function. ④The type of “giving up limb for keeping life'. ⑤The type of asking for amputated by patient and family members.Conclusion: ①Applied the theory of EBM, the limb amputation with damaged burned limbs is classified clinically ,which could provide the basis for doctors in talking to patients and family members, defining the amputation indication and operating principle and judging the prognosis. ② Not only the condition of the injury ,but also the medical devel-oping presently, the medical level of the region, the technical level of artificial limbs and the manner and economic base of the patients and their families have something to do with the faction to effect amputation, so the methods treating the same injury could be varied.
出处
《河南医学研究》
CAS
2004年第4期325-328,共4页
Henan Medical Research
