损伤控制外科技术在严重多发伤急救中的应用价值  

Clinical Application Value of Damage Control Surgery in Emergency of Severe Multiple Injury

作　　者：陈宁波[1] 陈仿[1] 曾杰[1] 李伟[1] 

机构地区：[1]四川省人民医院急救中心外科,四川省成都市610072

出　　处：《实用心脑肺血管病杂志》2011年第4期640-642,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨损伤控制外科技术(DCS)在严重多发伤急救中的应用价值。方法 2003—2009年我院急救中心外科收治的按DCS纳入标准入组的210例严重多发伤患者应用损伤控制外科技术,经ICU复苏待生命体征稳定后再实施确定性手术。结果 194例患者复苏后情况良好,APACHEⅡ评分明显低于复苏前,差异有统计学意义,再实施确定性手术后,痊愈出院。16例患者死于多器官功能衰竭或严重脑外伤。复苏期患者pH、PT、T和SO2监测指标与复苏期前患者相比差异有统计学意义。结论符合DCS指征的严重多发伤的患者,应积极实施DCS,根据损伤的不同部位和程度,分次手术治疗,可有效地缩短手术时间、减轻创伤应激、快速纠正创伤三联征,降低严重多发伤的病死率。Objective To study the clinical application value of damage control surgery（DCS） in emergency of severe multiple injury.Methods A total of 210 cases selected under the rules of DCS were treated by DCS from 2003 to 2006 years.The definitive operation was operated as soon as the vital signs became stable in ICU.Results 194 cases of Resuscitation in ICU was performed and the definitive operation was operated successfully.APACHEⅡScore obviously was lower than it before resuscitation.The distinction has phanero-significance.16 cases died of multiple organ failure or severe cerebral trauma.The body temperature,serum pH and prothrombin time（PT）level of patients during resuscitation in ICU were significantly different from those before resuscitation.Conclusion Cases of severe multiple injury selected under the rules of DCS should be treated by DCS actively.According to different injured location and degree,the damage control surgery can shorten the operating time,lessen the wound response,fast correct the trauma Triple-Symptom Complex and lower the death rate of severe multiple injury.

关 键 词：多发伤 损伤控制外科 确定性手术 

分 类 号：R641[医药卫生—外科学]