骨关节型严重多发伤的救治  

Treatment of severe polytrauma complicated by bone and joint injury

作　　者：张旭鸣[1] 邱美光[1] 林世水[1] 许志贤[1] 陈曙光[1] 施爱平[1] 于荣国[1] 

机构地区：[1]福建省立医院,福建省急救中心急诊外科,福州350001

出　　处：《中华创伤杂志》2011年第5期396-398,共3页Chinese Journal of Trauma

摘　　要：目的 探讨如何提高基于损伤控制外科理论的治疗在骨关节型严重多发伤中的效果.方法回顾性分析2006年1月-2009年6月应用损伤控制性手术治疗骨关节损伤为主的严重多发伤63例（平均ISS≥27分）的并发症、死亡率及骨折愈合关节功能恢复.结果61例创伤性休克中57例得到纠正,3例因失血性休克死于入院后2 h内,1例因严重颅脑外伤死于人院后11 h;1例因ARDS死于术后24 h;1例于伤后6 d因多器官功能衰竭死亡.52例骨折愈合,肢体功能恢复满意;2例行截肢术;3例轻度跛行,行走痛.结论损伤控制手术有助于骨关节型严重多发伤的救治,对临床救治严重创伤患者具很大指导意义.Objective To investigate the curative effect of damage control theory in treating severe polytrauma patients combined with bone and joint injury. Methods A retrospective study was done on data including complication, death rate, fracture healing and joint function recovery of 63 patients with severe polytrauma combined with bone and joint injury（ average ISS ≥27 points） admitted to our hospital from January 2006 to June 2009. Results Of all the patients, 57 shock patients were cured,three died of hemorrhagic shock within two hours after admission and one patient died of severe traumatic brain injury 11 hours after admission. One patient died of ARDS at 24 hours postoperatively and one died of multiple organ failure at day 6 after injury. Fracture healing was achieved in 52 patients, with satisfactory recovery of the limb function. Amputation was performed in two patients and three patients had mild claudication and pain walking. Conclusion Damage control strategy has great clinical significance in guidance of treatment of severe polytrauma combined with bone and joint injury.

关 键 词：多处创伤 骨折 损伤控制外科 

分 类 号：R687[医药卫生—骨科学]