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患者男性,32岁,因车祸致右大腿外伤4h入院。经摄片检查,拟诊“右股骨干下段闭合性骨折”收住院。给予右胫骨结节骨牵引以及术前常规检查。第2天诉患肢剧烈疼痛,检查足背动脉搏动良好,足趾活动自如,未引起重视。第3天上午出现高热,烦躁不安,右大腿高度肿胀,皮肤紫暗色,触皮下有捻发感,牵引针眼红肿有少许分泌物。急查血红蛋白4g％,尿常规:少许红、白细咆。X线显示:右大腿软组织积气,可见与肌束走行一致的长条型透亮阴影,分泌物涂片找到革兰氏阳性杆菌,考虑气性坏疽。即全麻下行右大腿高位开放截肢,术后因呼吸循环衰竭,经6h抢救无效死亡。
Male patient, aged 32, was admitted to hospital for a 4 h trauma to his right thigh due to an accident. After radiography, the proposed diagnosis of “right femoral shaft closed fracture” admitted to hospital. Right tibial tubercle traction and preoperative routine examination. On the second day complained of severe pain in limbs, check the dorsalis pedis artery pulsating well, toe activity freely, did not pay attention. Day 3 morning fever, irritability, the height of the right thigh swelling, dark purple skin, touch the skin under the hair twist, traction pinhole swelling a little secretions. Emergency check hemoglobin 4g%, urine routine: a little red, white roar. X-ray shows: the right thigh soft tissue gas, showing the same line with the muscle bundle translucent shadow, secretions smear found Gram-positive bacilli, consider gas gangrene. That underwent general anesthesia high right thigh open amputation, postoperative respiratory failure, died after 6h rescue.