| 摘要: |
| ［摘要］ 目的 总结10例下肢严重毁损伤保肢治疗的过程和经验。方法 回顾性分析2018-06～2019-05收治的10例下肢严重毁损伤患者的临床资料。所有患者在受伤后2～10 h内行清创缝合、外固定支架固定、血管神经肌腱吻合术、负压封闭引流（vacuum sealing drainage,VSD）治疗术等综合治疗。结果 7例患者患肢保全，其中5例能自行下地行走，功能评价满意，另2例术后功能恢复较差，行走跛行伴疼痛明显。2例患者因缺血性坏死伴感染，二期行大腿下段清创截肢术。1例因下肢毁损伤严重，术中即行下肢残端修整术。结论 正确评估下肢毁损伤程度，合理制定手术方案，能够增加保全肢体有效性，降低致残率，减轻患者心理与经济负担。 |
| 关键词: 下肢严重毁损伤 保肢 外固定支架 负压封闭引流 |
| DOI：10.3969/j.issn.1674-3806.2020.02.08 |
| 分类号:R 641 |
| 基金项目:全军医药卫生科研基金课题（编号：2007036010） |
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| Experience of limb salvage treatment for severe injury of lower extremities |
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XU Qian, ZHANG Xia, LIANG Zhi-bai, et al.
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The Second Department of Orthopedics, 910 Hospital of the Chinese People′s Liberation Army, Fujian 362000, China
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| Abstract: |
| ［Abstract］ Objective To summary the process and experience of limb salvage treatment of 10 patients with severe injury of lower extremities. Methods Retrospective analysis the clinical data of 10 patients with severe injury of lower extremities were summarized from June 2018 to May 2019. All the patients underwent debridement and suture, external fixation and stent fixation, neurovascular tendon anastomosis and vacuum sealing drainage(VSD) treatments within 2 to 10 hours after injury. Results The affected limbs of 7 patients were preserved among whom 5 cases could walk on their own, with satisfactory functional evaluation, and the other 2 cases had poor functional recovery after surgery, walking with a claudication and obvious pain. Two patients suffered from ischemic necrosis accompanied by infection and underwent second stage debridement and amputation of lower thighs. One patient received lower limb stump repair during srugery because the lower extremities were damaged. Conclusion Correct assessment of the damage degree of the affected lower limbs and reasonable formulation of operation plans can improve the effectiveness of limb preservation, reduce the disability rate and reduce the psychological and economic burden of the patients. |
| Key words: Severe injury of lower extremities Limb salvage External fixator Vacuum sealing drainage(VSD) |
