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小港醫院設立顯微外傷小組 一個月成功搶救2名工廠男斷臂@電傳媒

Posted On By 吳 富正

【電傳媒-記者吳富正、蔡佳芬/2020.07.09.高雄報導】

 【小港醫院】位居南高雄重工業區,除提供一般醫療服務外,由時任小港醫院傅尹志副院長(現岡山營運處執行長)所設立顯微外傷小組,召集骨科、整形外科、麻醉科與重症照護團隊,曾一個月成功救治2位南高雄需要進行緊急顯微手術的病患。

24歲陳先生在小港工業區工作,生日當天,他的整隻右上手臂不慎被機械截斷,被緊急送到小港醫院急診室救治。經過初步的診察後立即啟動[顯微外傷小組],立刻替陳先生進行斷臂再接的緊急手術,整個手術費時10小時,包含徹底清除所有傷口上的砂石、上臂骨頭固定、一條動脈、三條靜脈及三條神經吻合及前臂預防性筋膜切開術,後續又進行了植皮手術及小腿神經移植手術。

※50歲劉先生工作中整隻左手臂被機器扯斷,除左上臂被截斷外,還同時合併左氣血胸及第五到第十根肋骨骨折及右前臂骨折,手術後經小港醫院重症醫療團隊的持續救治,才成功同時保住劉先生的性命及手臂。

 成功救治這兩位病患的劉文智醫師表示,「斷臂再接」需要把握4小時黃金時間,迅速建立斷肢的血循及徹底清創才能減少組織壞死及感染的機會,接著才是進行一連串精細的顯微手術。斷臂時常合併多重外傷,整個團隊都得通力合作,才能同時保住病患的性命和手臂。

 高醫手外科呂俊寬醫師表示,被截斷的肢體務必要用生理食鹽水浸濕的紗布包裹好裝進塑膠袋裡,然後外層才用冰塊降低斷肢的溫度,千萬不要將斷肢直接與冰塊接觸,這樣才是正確延長斷肢的缺血時間的方式。但是遇到這類上臂大肢體截斷,其實很難妥善包紮保存,其實盡快將受傷的肢體與病患送醫治療,也是成功的關鍵之一。

 傅尹志執行長提及,積極復健治療很重要,早期避免關節僵硬、肌肉萎縮,晚期的肌力訓練,這樣才會有好的成果。假如手部功能恢復狀況不佳,未來可能還會需要進行肌腱轉移及游離功能性肌肉移植手術,來強化病患手部的功能。

 在【小港醫院】復健科團隊的努力之下,2位病患目前恢復狀況十分良好, 24歲的陳先生,目前的功能已經進展到手指已經能彎曲活動,50歲的劉先生由於原本傷勢較嚴重,但是在目前肩肘的活動功能也都逐漸恢復。

高雄市立小港醫院http://www.kmhk.org.tw/

高雄市小港區山明路482號(07)803-6783

人工掛號(07)805-9152[開放至16:00]

語音掛號(07)807-0210

吳 富正

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