海水浸泡子宫损伤的综合治疗

Combined Therapy of Uterus Trauma with Seawater Immersion

目的探讨海水浸泡子宫损伤的临床特点,观察综合治疗的效果。方法 37例海水浸泡子宫损伤伤员采用海水浸泡伤综合治疗法,包括早期用淡水或生理盐水对伤口、腹腔、盆腔、脏器的反复冲洗,抗休克、手术、早期纠正高渗透压、高钠血症、高氯血症,纠正酸中毒、抗感染、复温。观察伤口感染情况、临床治疗结果和子宫功能恢复情况。结果37例伤员中,伤口感染率为11%,全身感染率为8%;格拉斯哥预后评分(Glasgow outcome scale,GOS)优良率为62%,死亡率为14%;32例存活病人中,12个月功能恢复优良率为81%。结论海水浸泡子宫损伤临床主要特点是创伤因素多、严重的多发伤,海水浸泡所致伤口周围组织与重要器官严重的继发性损伤,伤口与全身感染率高且预后差。釆用综合治疗法可提高海水浸泡子宫损伤的疗效。

Objective To study the clinical characteristics of uterus trauma with seawater immersion and observe the therapeutic effect of combined treatment. Methods A total of 37 patients with uterus trauma with seawater immersion were underwent combined treatment including repeated wash of wounds and abdominal cavity and pelvic cavity and visceral organ with freshwater or normal saline,anti-shock,surgery,early correction of electrolyte imbalance and metabolic acidosis,anti-infection,and rewarming. The infection of wounds,clinical treatment and function recovery results were observed. Results In 37 cases,the wound infection rate was 11%,systemic infection rate was 8%,the excellent rate according to the Glasgow outcome scale( GOS)was 62%,the mortality was 14%,and the excellent rate of 12 months function recovery was 81% after trauma in the survival 32 cases. Conclusion The main clinical characteristics of uterus trauma with seawater immersion include more trauma factors and severe multiple trauma,severe secondary injury of tissues around the wounds and important organs,high wound and systemic infection rates and bad prognosis. The therapeutic effect of uterus trauma with seawater immersion can be improved by combined treatment.