小儿手部爆炸伤的分类与治疗

Classification and treatment of hand explosive injury in children

目的 总结小儿手部爆炸伤的损伤特点 ,探讨其诊治方法。方法 对 1990～ 2 0 0 0年收治的 78例小儿手部爆炸伤伤情和治疗过程进行回顾性分析 ,根据损伤特点 ,将爆炸伤分为撕裂伤、离断伤和毁损伤三种类型 ,撕裂伤清创后予以原位缝合 ,离断伤清创后急诊再植 ,毁损伤清创后采取Ⅰ期修复和延期修复两种方式 ,对毁损肢 (指 )体截肢或行各种功能重建术。结果 38例撕裂伤伤口Ⅰ期愈合 ,功能恢复好。 2 4例离断伤中 ,2 1例再植存活 ,功能恢复次于撕裂伤组。 16例毁损伤功能恢复最差 ,经延期修复者术后感染机会明显降低。结论 小儿手部爆炸伤严重妨碍其身体生长和心理发育 ,采取相应的防犯措施 。

Objective To analyze the characteristics, classification and treatment of hand explosive injury in children.Methods From 1990 to 2000, 78 children of hand explosive injury were followed-up and reviewed retrospectively. According to the features of injury, the trauma was divided into three types: Group 1. Lacerated injury (n=38), Group 2. Severed injury (n=24) and Group 3 Serious injury (n=21). The lacerated wound was primarily sutured after debridement, the severed injuries were replanted after debridement, and the serious injury were amputated or reconstructed primarily or delayed. Results The hand function of Group 1 recovered nearly to the normal range. The hand was successfully replanted with functional restoration of 21 cases in Group 2. The function recovery of 16 cases in Group 3 was the worst among the three groups. After a delayed suture the wound infection rate was obviously decreased. Conclusions The hand explosive injury not only influences on the physical constitution but also the mentally development of children. Efforts toward public education and legislation may help to prevent these harmful injuries.