切开减压联合血浆置换治疗挤压伤(英文)

CRUSH INJURY TREATED BY FASCIOTOMY AND PLASMA EXCHANGE

目的:探讨切开减压联合血浆置换治疗伴有肌红蛋白尿挤压伤的疗效。方法:伴有肌红蛋白尿挤压伤的病人为研究对象,共68例,随机分成A、B两组。A组36例行切开减压术后联合血浆置换。B组32例行传统方法治疗。比较两组的尿素氮、肌酐、急性肾功能衰竭发生率、伤口感染率及死亡率。结果:A组有4例发生急性肾功能衰竭,为11.1％,无1例死亡。B组有10例出现急性肾衰,为31.396(P<0.05),4例死亡,为12.5％。A组尿素氮、肌酐平均值低于B组(P<0.05)。A、B两组的感染率分别为19.4％(7例)和3.1％(1例)。结论:与传统方法相比,切开减压联合血浆置换治疗伴有肌红蛋白尿的挤压伤病人能够降低急性肾功能衰竭发生率及死亡率,在急性肾功能衰竭的预防和治疗中起着重要的作用。

Objective:To study the effect of the treatment for the crush injury with myoglobinuria by fascioto-my and plasma exchange. Methods:68 patients of the crash injury with myoglobinuria were studied and divided into A B two groups randomly,36 patients of A group were treated by fasciotomy and plasma exchange,32 patients of B group were treated by traditional method. Their Bun, Cr,the rates of the acute renal failure, infection and death were observed. Results: The acute renal failure, infection and death were observed in 4 (11. 1%),7(19.4%) and 0 (0%) patients at A group and in 10 (31.1%), 1(3. 1%) and 4(12. 5%)patients at B group ,the mean levels of Bun and Cr at A group were lower than those at B group (P<0.05). Conclusions:Comparing to the traditional method, the treatment for the crush injury with myoglobinuria by fasciotomy and plasma exchange can decrease the rate of acute renal failure and death. It plays important role in the prevention and treatment of the acute renal failure caused by crush injury.