CAJ | 학술논문

目的探讨损伤控制原则在严重多发锐器伤伴断肢(指)救治中的临床应用.方法对多发伤损伤40例,严重度评分(ISS)≥16分者,其中伴断腕11例、断掌9例、断指9例、前臂离断8例、肘部离断3例.在多科协作积极救治多发伤的同时,清创离断肢(指)体,一期行断肢(指)再植,术后待病情稳定后,早期进行肌腱修复.结果临床治疗40例,再植肢(指)全部成活,术后随访0.5～3.0年,根据断肢再植功能评定标准评定:优8例,良21例,中7例,差4例,优良率为72.5%.结论多科合作、早期救治多发伤,应用显微外科技术是提高多发伤伴断肢(指)再植成功率的关键.
목적 탐토손상공제원칙재엄중다발예기상반단지(지)구치중적림상응용.방법 대다발상손상40례,엄중도평분(ISS)≥16분자,기중반단완11례、단장9례、단지9례、전비리단8례、주부리단3례.재다과협작적겁구치다발상적동시,청창리단지(지)체,일기행단지(지)재식,술후대병정은정후,조기진행기건수복.결과 림상치료40례,재식지(지)전부성활,술후수방0.5～3.0년,근거단지재식공능평정표준평정:우8례,량21례,중7례,차4례,우량솔위72.5%.결론 다과합작、조기구치다발상,응용현미외과기술시제고다발상반단지(지)재식성공솔적관건.
Objective To explore the strategy of damage control in clinic treatment of severe limb (finger) with multiple injuries.Methods Severe multiple injuries patients with ISS evaluation more than 16 points were chosen for this study.Simple replatations of severed limb(finger) were perfored in 40 patients while their multiple injuries were actively treated.Results Among the 40 cases, all cases survived.1-3 years follow-up showed that the results were excellet in 8, good in 21, middle in 7, and poor in 4, with an excellent or good rate of 72.5 percent.Conclusion Multiple specialties cooperation, early treatment of multiple injuries and experienced microsurgery operation are the keys to improve success rate of replantation of severed limb(linger) with multiple injuries.