肢体损伤综合征治疗的探讨

Exploration of Treatment of the Mangled Extremity Syndrome

目的:探讨肢体损伤综合征的治疗。方法:通过对我科72例肢体损伤综合征进行肢体损伤综合征指数评分,研究伤肢截肢或保肢的适应证,分析了清创的方法。结果:72例中64例MESI评分<20,8例MESI评分≥20。64例MESI值<20者保肢成功,8例MESI值≥20者中6例早期截肢,1例晚期截肢,1例保肢成功。截肢组与保肢组的MESI值有明显差异(P<001)。结论:MESI评分标准是预测早期截肢或保肢的准确有效的标准,反复多次清创是治疗肢体损伤综合征的关键。

Aim:To explore the treatment of the mangled extremity syndrome.Methods:An analysis of the indication of amputation or salvage of the limbs had been made on 72 cases with mangled extremity syndrome (MES) by using a grading method mangled extremity syndrome index (MESI).Application of debridement was analyzed.Results:64 cases with MESI score<20 succeeded in having their limbs savaged.8 cases with MESI score≥20,6 of them had their limbs primarily amputated,1,having received operation early,ultimately required amputation and 1 had his limb salvaged.The MESI score between the amputation and salvage shows a significant difference ( P <0 01).Conclusion:The grading method of MESI is an accurate and effective criteria for determining early amputation versus salvage of the limb in victim.The key for the treatment of the patient suffering from MES is repeating debriement.