高压氧综合治疗小儿外伤后气性坏疽67例效果分析

The Clinical Effect 67 patients of Hyperbaric Oxygen on Infantile Traumatic Gas Gangrene

目的 探讨小儿外伤后气性坏疽的早期诊断及高压氧（hyperbaric oxygen,HBO）综合治疗方案的疗效.方法 选择外伤后气性坏疽患儿67例,经急诊手术治疗后即采用高压氧治疗,每日两次,7次疗法,压力0.8～0.25 MPa,并配合抗炎、每日换药及对症处理.结果 67例患儿经HBO治疗后,复查梭状芽胞杆菌1日转阴率96.92％,2日转阴率100％.13例未行再次截肢,54例肢体保存,未发生继发、交叉感染和扩散.伤口痊愈,治愈率100％.结论 小儿外伤后气性坏疽早期症状、体症不典型,临床医师应提高警惕,抓住最佳时机,及早诊疗.合理、有效的高压氧抢救性治疗方案,配合手术、抗炎、换药等综合治疗,能最大限度缩小组织坏死范围,预防并发症的发生,有效保存肢体,降低截肢率,提高生存率及治愈率.

Objetive To observe the clinical effect of hyperbaric oxygen on infantile traumatic gas gangrene.Methods 67 cases of pediatric trauma patients with gas gangrene after emergency operation were included in this study.The clinical treatment was hyperbaric oxygen therapy.The patients all received hyperbaric oxygen therapy two times a day with the pressure between 0.8-0.25 MPa.In addition,with anti-inflammatory and symptomatic treatment,the daily dressing.The incidence of complications were compared among different groups by chi-square test using the spss 18.0.Results 67 patients were treated with HBO.The negative rate of clostridia within one day was 96.92％.And negative rate was 100％ within two days.There were 13 cases without re-amputation and 54 cases of limh preservation.There was no secondary,cross infection and spread.The wound has healed,the cure rate was 100％.Condusion The symptoms of infantile traumatic gas gangrene were not typical,doctors must promote awareness.The reasonable effective treatment project of hyperbaric oxygen is worth being used in the clinic.