中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
10期
1014-1017
,共4页
王敬博%臧加成%于树军%张文海%王裕民
王敬博%臧加成%于樹軍%張文海%王裕民
왕경박%장가성%우수군%장문해%왕유민
股骨骨折%骨折固定术,内%早期诊断
股骨骨摺%骨摺固定術,內%早期診斷
고골골절%골절고정술,내%조기진단
Femoral fractures%Fracture fixation,internal%Early diagnosis
目的 探讨双侧股骨干骨折致伤机制、损伤特点,以制订正确的早期治疗策略.方法 2009年12月-2012年6月收治双侧股骨干骨折患者25例,其中男18例,女7例;年龄17 ～40岁,平均31.2岁.致伤原因:交通伤19例,重物砸伤6例.闭合性骨折47侧,开放性骨折3侧.32侧股骨干骨折行髓内钉固定,18侧行钢板固定.记录患者ISS、血常规和血液生化指标、住院期间应用血液及血浆数量及患者住院时间. 结果 患者ISS(14.6±5.2)分,术前准备时间(10.1 ±3.7)d,住院治疗时间(28.9±8.4)d.入院后患者红细胞(3.0±0.4)×1012/L,血红蛋白(86.0±13.5) g/L,血浆总蛋白(47.0±10.6)g/L,血浆白蛋白(31.4±6.5) g/L,谷草转氨酶(124.1±95.1)U/L,谷丙转氨酶(114.2±107.1) U/L,肌酸激酶(1 848.7±1 044.8) U/L;与标准值比较差异均有统计学意义(P ＜0.05或0.01).23例术前输血(1444.4±726.5) ml,19例输血浆(305.6±98.3) ml.患者术中及术后输血(2005.7±1 153.1)ml. 结论 双侧股骨干骨折早期治疗以稳定生命体征为主,待病情稳定后,可同期行髓内钉或钢板固定.
目的 探討雙側股骨榦骨摺緻傷機製、損傷特點,以製訂正確的早期治療策略.方法 2009年12月-2012年6月收治雙側股骨榦骨摺患者25例,其中男18例,女7例;年齡17 ～40歲,平均31.2歲.緻傷原因:交通傷19例,重物砸傷6例.閉閤性骨摺47側,開放性骨摺3側.32側股骨榦骨摺行髓內釘固定,18側行鋼闆固定.記錄患者ISS、血常規和血液生化指標、住院期間應用血液及血漿數量及患者住院時間. 結果 患者ISS(14.6±5.2)分,術前準備時間(10.1 ±3.7)d,住院治療時間(28.9±8.4)d.入院後患者紅細胞(3.0±0.4)×1012/L,血紅蛋白(86.0±13.5) g/L,血漿總蛋白(47.0±10.6)g/L,血漿白蛋白(31.4±6.5) g/L,穀草轉氨酶(124.1±95.1)U/L,穀丙轉氨酶(114.2±107.1) U/L,肌痠激酶(1 848.7±1 044.8) U/L;與標準值比較差異均有統計學意義(P ＜0.05或0.01).23例術前輸血(1444.4±726.5) ml,19例輸血漿(305.6±98.3) ml.患者術中及術後輸血(2005.7±1 153.1)ml. 結論 雙側股骨榦骨摺早期治療以穩定生命體徵為主,待病情穩定後,可同期行髓內釘或鋼闆固定.
목적 탐토쌍측고골간골절치상궤제、손상특점,이제정정학적조기치료책략.방법 2009년12월-2012년6월수치쌍측고골간골절환자25례,기중남18례,녀7례;년령17 ～40세,평균31.2세.치상원인:교통상19례,중물잡상6례.폐합성골절47측,개방성골절3측.32측고골간골절행수내정고정,18측행강판고정.기록환자ISS、혈상규화혈액생화지표、주원기간응용혈액급혈장수량급환자주원시간. 결과 환자ISS(14.6±5.2)분,술전준비시간(10.1 ±3.7)d,주원치료시간(28.9±8.4)d.입원후환자홍세포(3.0±0.4)×1012/L,혈홍단백(86.0±13.5) g/L,혈장총단백(47.0±10.6)g/L,혈장백단백(31.4±6.5) g/L,곡초전안매(124.1±95.1)U/L,곡병전안매(114.2±107.1) U/L,기산격매(1 848.7±1 044.8) U/L;여표준치비교차이균유통계학의의(P ＜0.05혹0.01).23례술전수혈(1444.4±726.5) ml,19례수혈장(305.6±98.3) ml.환자술중급술후수혈(2005.7±1 153.1)ml. 결론 쌍측고골간골절조기치료이은정생명체정위주,대병정은정후,가동기행수내정혹강판고정.
Objective To investigate the mechanism,injury characteristics,and early interventions of bilateral femoral shaft fracture.Methods Twenty-five cases of bilateral femoral shaft fracture treated between December 2009 and June 2012 were enrolled in the study.Eighteen patients were males and 7 were females with mean age of 31.2 years (range,17-40 years).Nineteen cases were injured due to traffic accidents and 6 due to the hit by heavy objects.There were 47 sides with closed fracture and 3 sides with open fracture.Intramedullary nailing was performed at 32 sides and plate fixation was used at 18 sides.ISS,blood routine,some blood biochemical items,blood or plasma use,and hospitalization days were measured.Results ISS was (14.6 ± 5.2) points.Preoperative readiness time and hospital stay were (10.1 ± 3.7) days and (28.9 ± 8.4) days respectively.After hospitalization,measured values were (3.0 ± 0.4) × l012/L for red blood cells,(86.0 ± 13.5) g/L for hemogIobin,(47.0 ± 10.6) g/L for total protein,(31.4 ± 6.5) g/L for albumin,(124.1 ± 95.1) U/L for aspartate aminotransferase,(114.2 ± 107.1) U/L for alanine aminotransferase,and (1 848.7 ± 1 044.8) U/L for creatine kinase with significant differences from the reference ranges (P ＜ 0.05 or 0.01).Amount of blood transfused for 23 cases was (1 444.4 t 726.5) ml and plasma transfused for 19 cases was (305.6 ± 98.3) ml before operation.Volume of intra-and post-operative blood transfusion was (2 005.7 ± 1 153.1) ml.Conclusions Stabilization of vital signs predominates the early treatment of bilateral femoral shaft fracture.After the condition is stable,intramedulary nailing or plating can be performed concurrently.
