损伤控制性手术在多发骨折为主的严重多发伤中的应用  

Damage control operation for treating multiple injury patients complicated with multiple fracture

作　　者：杨洪昌[1] 陈仲[1] 吴兆祥[1] 李滔[1] 季建华[1] 马志坚[1] 陈戈[1] 

机构地区：[1]云南省第二人民医院创伤中心云南省创伤救治中心,云南昆明650021

出　　处：《创伤外科杂志》2009年第6期515-517,共3页Journal of Traumatic Surgery

摘　　要：目的探讨如何应用损伤控制性手术治疗严重多发骨折及疗效。方法回顾性分析云南省创伤救治中心2005年1月-2008年3月应用伤害控制性手术治疗的多发骨折为主的严重多发伤49例（ISS≥25分）的围手术期并发症、死亡率及骨折愈合关节功能恢复。结果43例创伤性休克中41例得到纠正。1例因门静脉毁损死于术中;1例骨折临时固定后送入ICU生命支持,于伤后11小时死亡;1例于伤后17天多器官功能衰竭死亡。1例剖腹探查术中呼吸心跳骤停进行心肺复苏成功存活。1例胫腓骨骨折急诊外固定支架固定,伤后7天更换髓内钉固定后发生局限性骨髓炎,经开窗引流、开放植骨后痊愈。46例病例骨折愈合,肢体功能恢复满意。结论对严重多发性骨折严重多发伤病人应用伤害控制手术治疗,效果满意。骨折早期治疗强调外固定支架尽早适当复位固定骨折,多次创口清创及应用VSD覆盖创面。Objective To investigate the curative effect of damage control operation for treating multiple injury patients complicated with multiple fracture. Methods There were 49 multiple injury patients complicated with multiple fracture, admitted to our hospital from Jan. 2005 to Mar. 2008. Their data including peri-operative complication, death rate and function repair of fracture-healing joint were retrospectively reviewed. Results Totally 46 patients ＇fractures healed. One case died in the process of operation because of portal vein injury, one because of multiple organ failure,and one died 11 hours after injury in the ICU. Conclusion The curative effect of damage control operation for treating multiple injury patients complicated with multiple fracture is satisfying. In the early treatment for fracture, external fixator for repairing fracture, repeated wound - debriding and VSD covering wound surfaces should be emphasized.

关 键 词：损伤控制 多发性骨折 手术 

分 类 号：R683[医药卫生—骨科学]