伤害控制骨科学原则在严重多发创伤中的应用  

Application of treatment in multiple traumas with multiple fractures by damage control orthopedics strategy

作　　者：蒋涛[1] 彭加英[1] 冯敬[1] 

机构地区：[1]四川省绵阳市第三人民医院骨科,621000

出　　处：《重庆医学》2009年第20期2542-2543,共2页Chongqing medicine

摘　　要：目的探讨伤害控制骨科学(DCO)在严重多发创伤合并多处骨折患者救治中的临床应用。方法对2006年3月至2009年3月收治的以DCO原则处理的35例严重多发创伤合并多处骨折患者的临床资料进行分析。结果患者损伤包括四肢骨干骨折、骨盆骨折、脊柱骨折及颅脑、胸腹部等其他系统损伤,平均损伤严重程度评分(ISS)=28.7±3.2分,格拉斯哥昏迷评分(GCS)=9.2±2.1分。死亡1例,大腿截肢2例,胫骨骨折发生不愈合2例,经再次手术最后愈合;其余30例骨折愈合,未出现严重并发症,肢体功能恢复满意。35例中28例患者重新回到以前的工作岗位。结论对严重多发伤合并多发性骨折患者使用伤害控制策略治疗,争取尽快恢复患者体能,降低手术风险,从而减少后遗症和并发症的发生,可改善患者预后。Objective To discuss the clinical application and results of the damage control orthopedics strategy in the treatment of multiple traumas combined with bone injury. Methods Analysis was performed on 35 cases of patients from March 2006 to March 2009,whom with severe multiple traumas we treated with DCO strategy in our department. Results Patients damage indud- ed limb fractures, pelvic fractures, spine fractures and other system damag, such as craniocerebral and chest damag, and average ISS score was 28.7 ,GCS was 9.2. One death,leg amputation in 2 cases,tibia fractures occur nonunion in 2 cases,but both were healing by reoperation in the end,and the rest of 30 cases were healing, no serious complications, limb function recovered satisfactorily. In all cases, twenty-eight patients went back to the previous jobs. Conclusion Using damage control strategy in severe multiple trauma combined multiple fractures can improve the prognosis of patients and reduce surgical risk.

关 键 词：伤害控制 多发伤 骨折 应用 

分 类 号：R641[医药卫生—外科学] R683[医药卫生—临床医学]