手部化学液体高压注射伤11例的治疗

Treatment experience of chemical liquid high-pressure injection injury of 11 cases in hand

目的 探讨手部化学液体高压注射伤的临床治疗.方法 对11例手部化学液体高压注射伤患者,采用一期清创、减压、冲洗引流,二期行游离植皮或腹部皮瓣修复.结果 所有患者均获术后随访,时间4～13个月,平均8.5个月,根据TAM功能评定法评价：优7例,良3例,差1例.结论 手部化学液体高压注射伤是一种严重的复合性损伤,临床易失治误治,致残率很高.这种损伤后期基本都会出现组织坏死,早期切开减压、彻底清创、开放引流、延期闭合创口是目前治疗手部化学高压注射伤最主要、有效的方法.

Objective To investigate the clinical treatment of the high-pressure injection injuries of the hand by chemical liquids.Methods 11 patients with chemical high pressure gun injection injury in hand were given early surgical debridement,decompression,flushing drainage,then in the second phase the skin grafting or free flap transplantation were used to close wound.Results All patients received postoperative follow-up,follow-up time：4 to 13 months （mean 8.5 months）.According to TAM evaluation method for the functional assessment：excellent in 7 cases,good in 3 cases,poor in 1 case poor.Conclusion chemical liquid high pressure injection injury in hand is a serious compound injury,easily lost to disease,disability rate is very high.Soft tissue necrosis appear in late stage,treatment should be as far as possible early incision decompression,thorough debridement,open drainage,it is the most main and valid method of the treatment of hand chemical high pressure spray gun injection hurt to defer closing wound.