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冷冻截肢作为严重烧伤的一种临时措施。

Cryoamputation as a temporizing measure in severe burn injury.

作者信息

Pennington J Daniel, Wall Anji E, Schlesinger Joseph J, Higdon Kent K, Weavind Liza

机构信息

From the Departments of *General Surgery, †Anesthesiology and Critical Care Medicine, ‡Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; and §Department of Radia tion Oncology, UCLA Medical Center, Los Angeles, California.

出版信息

J Burn Care Res. 2014 Jul-Aug;35(4):e273-5. doi: 10.1097/BCR.0000000000000063.

Abstract

Cryoamputation, or physiologic amputation, is a well-described procedure typically used to amputate gangrenous lower extremities. In such cases the patient is too unstable for transport to the operating room, so cryoamputation using dry ice or other refrigerant allows for immediate bedside intervention and later operative amputation when the patient is more stable. In this study the authors describe the use of cryoamputation to stabilize a burn patient with a nonviable upper extremity considered to be contributing significantly to his metabolic acidosis. This experience suggests that cryoamputation may be a reasonable technique to consider when a burn patient presents with a nonviable extremity but is too unstable for immediate operative amputation.

摘要

冷冻截肢术,即生理性截肢术,是一种已被充分描述的手术,通常用于截肢坏疽的下肢。在这种情况下,患者病情过于不稳定,无法转运至手术室,因此使用干冰或其他制冷剂进行冷冻截肢术可在床边立即进行干预,并在患者病情更稳定时进行后续的手术截肢。在本研究中,作者描述了使用冷冻截肢术来稳定一名烧伤患者,该患者上肢已无生机,被认为是导致其代谢性酸中毒的重要原因。这一经验表明,当烧伤患者出现肢体无生机但病情过于不稳定而无法立即进行手术截肢时,冷冻截肢术可能是一种值得考虑的合理技术。

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