Bialik I F, Borovkova T F, Vasina T A, Zviezdina M V, Zimina L N, Galstukhov A V, Okhotskiĭ V P, Chetverushkin B V
Sov Med. 1989(10):18-21.
The results of treatment of 36 patients injured during the earthquake in Armenia are analyzed. The patients had severe traumas: open injuries to the limbs, complicated by nephro- and hepatopathies. The periods of the limb crushing with fragments of ruined buildings varied from 3 hours to 3 days. The treatment modalities included conservative and operative detoxication (hemoperfusion, hemodiafiltration, hemofiltration, prolonged endolymphatic infusions of drugs), active surgical strategy, rehabilitation of patients. Seven amputations, 7 reamputations, and 21 necrectomies were performed in 36 patients by vital indications; no lethal outcomes were recorded. Restorative skin plasty was performed in 14 patients with 19 limb stumps, with good functional outcomes. The patients were directed to the Central Research Institute of Prosthetics to be supplied with prostheses. Only in 3 patients with the upper limb crushing the development of stable ischemic contractures could not be prevented.
分析了亚美尼亚地震中36名受伤患者的治疗结果。这些患者遭受了严重创伤:四肢开放性损伤,并伴有肾病和肝病。被毁坏建筑物碎片挤压肢体的时间从3小时到3天不等。治疗方式包括保守和手术解毒(血液灌流、血液透析滤过、血液滤过、长时间内淋巴药物输注)、积极的手术策略以及患者康复。36例患者根据生命指征进行了7次截肢、7次再次截肢和21次坏死组织切除;未记录到死亡病例。14例患者的19个肢体残端进行了修复性皮肤整形,功能恢复良好。患者被送往中央假肢研究所安装假肢。仅3例上肢挤压伤患者未能预防稳定缺血性挛缩的发生。