头枕部高压电接触伤的救治

Management of High Voltage Electricity Injury in Occipital Region

目的:探讨头枕部高压电击伤的临床发病特点和治疗措施。方法:对7例头枕部高压电击伤病人进行回顾性分析。结果:6例病人治愈,1例病人死亡。7例均有突出的中枢神经损伤症状:昏迷、高热、肌张力增高和病理反射等,且伤后2天、3天多有反复,内脏器官损伤重,液体复苏量较大,创面深,多需皮瓣组织修复,截肢伤残率高。结论:头枕部高压电击伤的中枢神经系统损伤重,病情复杂,伤残率高,治疗中要特别突出脏器功能的支持,特别是对脑水肿的治疗,尽早封闭创面。

Objective: To investigate the clinical characteristics of high voltage electricity injury in occipital region and effective treatment method for this kind of injury. Methods: 7 cases with high voltage electricity injury in occipital region were analyzed retrospectively. Results: 6 cases were cured and 1 died. All patients appeared transparent central nervous injury symptoms such as coma, high fever, high muscular tension and pathologic reflex. Those signs could be found many times with 2-3 days. Their internal organs were injured heavily. More liquid was used for resuscitation. All patients wounds were deep and needed repairing by using flap. The amputated extremity rate was high in those patients. Conclusion: The central nervous injury was severe in this kind of cases. Their situation was usually complicated and disablement rate was high. The supporting treatment for the organs' function was important, especially for the management of brain edema. The wound should be covered as soon as possible.