肢体枪伤治疗的新方法(英文)

New approach in the treatment of the wounded with gunshot fractures of limbs

目的分析四肢枪伤骨折后髓外骨缝合术和病灶外骨缝合术联合淋巴细胞敏感的抗生素治疗的效果。方法分析肢体枪伤合并骨折的患者。31例患者(42.5%)接受了髓外骨缝合术联合抗生素治疗(对照组),42例患者(57.5%)接受病灶外骨缝合术联合抗生素治疗(试验组)。结果试验组41例患者(93.8%)伤口愈合出院,平均住院时间是(8.7±0.3)天;而对照组25例患者(80.5%)伤口愈合出院,平均住院时间为(31.5±1.3)天,试验组伤口愈合率和平均住院时间均优于对照组(P<0.01)。所有的患者均未出现并发症。结论淋巴细胞敏感的抗生素治疗肢体骨折适用于髓外骨缝合,这种治疗方法也适用于病灶外骨缝合术并发广泛软组织损伤的患者。

Objective The objective of this study is an analysis of the treatment results of gunshot bone fractures of extremities with extramedullary and extrafocal osteosynthesis against lymphotropic antibiotic therapy （LA） with regional lymph stimulation （RLS）. Methods We observed patients with gunshot fractures of the extremities. Extramedullary osteosynthesis was performed to 42.5% of the patients, extrafocal in 57.5%. In the control group, the antibiotic therapy was carried out in the traditional way in the postoperative period. Results The proposed methodology has allowed us to achieve wounds healing by primary pulling in 93.8% of patients. Length of hospital stay was 8.7±0.3 days. The wound healing rate in the control group was 80.5%. Length of hospital stay was （31.5±1.3） days （P〈0.01）. In all cases, the wound healed without complications. Outpatient rehabilitation lasted for 5.2±0.7 days. Conclusion The use of LA with RLS in the comprehensive treatment of gunshot fractures allowed to apply the primary extramedullary osteosynthesis and in cases of extensive soft tissue injury the extrafocal osteosynthesis with minimal infectious complications.