创伤性截肢的生化指标监测及其对临床治疗的指导研究

Clinical Study of Monitoring Physiological and Biochemical Indicators after Traumatic Amputation of Extremities and Its Effects on the Treatment

目的分析总结严重挤压伤导致四肢创伤性截肢各种生化指标的动态变化及对临床中治疗的指导意义。方法 2000年3月-2011年3月对23例由于严重挤压导致创伤性截肢的患者各项生化指标检测结果进行实时监控,根据监控结果及时调整治疗方案。结果伤后患者电解质,血、尿肌红蛋白,尿比重,尿pH值,血肌酸激酶、肌酸激酶同工酶、羟丁酸脱氢酶、白蛋白、血红蛋白、血小板等指标均有明显改变,据此作为救治的依据进行精细化治疗。术后随访7个月～10年,23例患者均得到康复,肾功能良好。结论对于严重挤压伤导致四肢创伤性截肢的各种生化指标实时监控并同步制定精细化治疗,才能确保患者成功救治并得以康复。

Objective To investigate the monitoring of physiological and biochemical indicators after traumatic amputation of extremities caused by severe crush injury and its clinical significance on the treatment. Methods Between March 2000 and March 2011, 23 patients underwent traumatic amputation of extremities due to severe crush injuries. Their physiological and biochemical indicators were monitored and the therapies were adjusted based on these indicators. Results The therapies for all the 23 patients were adjusted carefully based on the changes of such indicators as electrolyte, serum and urine myoglobin, urine specific gravity, urine PH variation, serum creatine kinase, serum creatine kinase BB, hydroxybutyrate dehydrogenase, albumin, hemoglobin, and platelet. During the follow-up for 7 months to 10 years, all the 23 patients recovered well with good renal function. Conclusion Real-time monitoring of physiological and biochemical indicators and delicate therapies adjusted according to the results of the monitoring can assure successful recovery of the patients.