腕部电烧伤肢体远端继发性坏死原因分型及治疗

THE CAUSAL CLASSIFICATION AND TREATMENT FOR SECONDAARY DISTAL NECROSIS OF CARPUS ELECTRIC BURN

１９８５年１月至１９９４年５月，我科共收治腕部电烧伤５４例、共７８个腕部受损。其中肢体远端原发性坏死者２５例，肢体远端继发性坏死及有继发性坏死倾向者１６例，占腕部电烧伤２０．５％（１６／７８）。继发性坏死者８例，有继发性坏死倾向经积极抢救治疗保住肢体者８例。在临床实践中，我们观察到腕部电烧伤远端肢体继发性坏死可分为三种类型：供血不足型，以动脉阻塞为主；血液瘀滞型，以静脉阻塞为主；血液粘滞度升高型，表现为微血管阻塞。并针对三种类型采用扩血管药物和抗血小板药物等不同预防治疗方法，临床上降低了截肢率，取得较为满意的效果。

Form January 1985 to May 1994,we had been treating 54 cases,totally 78carpuses of electric burn,which including 25 cases of primary and 16 cases of secondary andtendency of secondary distal necrosis which is 20.5%of totally 78 carpuses. 8 cases are sec-ondary distal necrosis,another 8 cases which inclineing to necrosis had been saved after aclivetreatment.We have obscrvcd that it can be clssified out as three types:Blood insufficiency inwhich artery block is predominant;Blood stasis in which vein obstruction playing a superiori-ty;Blood viscosity increasing in which micro-blood vessel blocked.We have used differenttheraples such as blood vesscl dilatation drugs and antiplatelet drugs etc.to prevent andtreat thesc three types of patients,the ampuation rate is lower,and clinical result is satisfac-tory.