华西医院地震康复中心地震挤压伤截肢伤员的伤情分析

The Analysis of Patients with Crush Injury in Wenchuan Earthquake Treated in Earthquake Rehabilitation Center of West China Hospital

目的：了解地震截肢伤员的伤情特点，为其康复提供依据。方法：2008年6月～2008年12月31日，华西医院康复中心收治33例地震伤截肢患者，观察分析其伤情特点和康复治疗变化。结果：男性15例（45．5％），女性18例（54．5％）；男性与女性的年龄相比无统计学意义（P〉0．05）；10～19岁青少年45．45％；学生51．52％，在职人员33．33％；重物砸伤占78．79％；膝上截肢占43．90％，上肢截肢21．95％，下肢78．05％；截肢合并症13种，肾功衰最多，占28．57％；手术次数平均2．55次；残端有2例愈合差，有14名培养出细菌；日常生活活动能力Barthel指数入院时50．92±16．76，出院时77．77±14．37。结论：地震截肢伤员伤情重，残端情况差，康复治疗效果明显。

Objective： To analyze the clinical characteristics and rehabilitation treatment of amputees in the provincial rehabilitation center built by the government after the earthquake, who wounded in the earthquake. Methods： During June 2008 to December 31, 2008, 33 cases of amputees caused by earthquake were treated in Rehabilitation Center of West China Hospital and the characteristics of their injuries and rehabilitation curative effects were analysed. Results： Fifteen cases were male （45.5 %） while 18 （54.5 %） were female; there was no significant difference between the age of the wounds and sex. Young people aged between 10-19 reached 45. 45%; students reached 51. 52%, serving officers reached 33. 33%; heavy injury accounted for 78.79% of the totall supraknee amputations accounted for 43.90%, percentage of upper limb amputations was 21.95 %, which was lower than that of lower limb amputation （about 78.05 %）; there were 13 kinds of complications, in which renal failure was the most common, accounting for 28.57% ; the average of surgery was 2.55 times per patient; there were two cases who caught indolence, 14 cases developed bacteria in stump; activity of daily living （ADL） score at discharge （77.77±14.37） was greater than that at admission （50.92±16.76）. Conclusion： Rehabilitation takes significant curative effects on the amputees treated in the provincial rehabilitation center, whose stump condition is poor.