目的:总结分析25例地震伤致气性坏疽伤员的救治经验,探讨救治方案,为临床工作提高参考。方法:回顾性研究25例地震伤致气性坏疽伤员的早期临床表现,诊断方法,隔离措施、临床管理及其预后。结果:共收治25例气性坏疽伤员,无一例死亡。院外诊断7例,院内诊断18例。截肢18例,开放性截肢12例,非开放性截肢6例;扩创7例。发生急性肾功能衰竭2例,行血液透析治疗后肾功能恢复;无院内交叉感染的发生。结论:早期诊断、治疗、早期隔离及全面、系统护理可以提高临床救治水平,改善患者的预后,避免院内交叉感染的发生。
Objective To investigate the efficacy of interdisciplinary therapy in critically ill patients with gas gangrene in the 2008 W enchuan earthquake.Methods Four critically wounded patients with gas gangrene caused by Wenchuan earthquake were treated by interdisciplinary cooperation.Results Two patients received debridement and decompression were not amputated.Two amputated patients did not received futher amputation.Conclusions Interdisciplinary therapy of critically ill patients with gasgangrene in earthquake could limited the area of tissue necrosis,minimized the necessity of amputation and further amputation.
Objective To find effective ways for controlling the hospital infection to the skeptical gas gangrene patients. Method From May 14th to June 24th, the hospital set up triage spots originally and dealt with the wounded based on their specific conditions in different stages and optimized the flow of admission of the wounded. Owing to correctly treating the wound and screening the skeptical gas gangrene patients, preventing nosocomial infections was shifted forward. Sprending the gas gangrene wound after having flushed it with 3% H2O2. If the wound have been stitched, the stitches should bee taken out, and open the wound and take the debridement for it completely, then treat it with b antibacterial after debridement by sterilization and isolation about operation of gas gangrene. Result Up to June 24th, none of 67 cases of doubtful gas gangrene from the disaster area died and no hospital cross infections happened in courtyard. At present, amomg the 67 cases, 32 were highly suspected of gas gangrene infection, 26 cases were discharged, while 6 cases were undergoing treatment in the hospital. Conclusion Correct management and appropriate treatment are effective ways for controlling hospital cross infection to the skeptical gas gangrene patients.