海水浸泡女性会阴部严重开放性损伤临床治疗研究

Clinical Treatment Study on the Female Serious Perineal Open Wound with Seawater Immersion

目的探讨海水浸泡女性会阴部严重开放性损伤的临床特点,观察综合治疗的效果。方法 31例海水浸泡女性会阴部严重开放性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、多发伤的手术、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。结果 31例伤员中,伤口感染率为29%,全身感染率为16%;格拉斯哥预后评分(Glasgow outcome scale,GOS)优良率52%,中度昏迷率16%,重度昏迷率13%,死亡率19%。结论海水浸泡女性会阴部严重开放性损伤临床主要特点是伤因多、创伤机制复杂、严重的多发伤、感染重、海水浸泡伤临床表现突出,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,全身感染率高且预后差。釆用综合治疗法可提高海水浸泡女性会阴部严重开放性损伤的疗效。

Objective To study the clinical characteristics of the female serious perineal open wound with seawater immersion and observe the therapeutic effect of combined treatment. Methods A total of 31 female patients of serious perineal open wound 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,multiple injury surgery,early correction of electrolyte imbalance and metabolic acidosis,anti-infection. The infection of wounds,clinical treatment results were observed. Results In 31 cases,the wounds infection rates was 29%,systemic infection rate was 16%,the excellent rate according to the Glasgow outcome scale( GOS) was 52%,moderate disability was 16%,severe disability was 13%,mortality was 19%. Conclusion The main clinical characteristics of female serious perineal open wound with seawater immersion include more trauma factors and complex injury mechanism,severe multiple trauma,heavy infection,prominent clinical performance of seawater immersion wound,severe secondary injury of tissues around the wounds and important organs,high wound and systemic infection rates and bad prognosis.The therapeutic effect of female serious perineal open wound with seawater immersion can be improved by combined treatment.