损伤控制指导治疗不稳定型骨盆骨折的临床分析  

Clinical analysis of treatment of unstable pelvic fracture guided by damage control orthopaedics(DCO)

作　　者：张开欣[1] 董凌岱[1] 郭兴杰[1] 

机构地区：[1]青岛大学医疗集团莒县人民医院骨科,山东276500

出　　处：《中国矫形外科杂志》2011年第22期1869-1872,共4页Orthopedic Journal of China

摘　　要：[目的]探讨应用骨科损伤控制理论指导治疗不稳定型骨盆骨折的意义,规范不稳定型骨盆骨折的治疗。[方法]本组39例不稳定型骨盆骨折,在骨科损伤控制理论指导下,首先采取各种措施稳定生命体征,过渡性简单外固定,然后实施有效内固定恢复骨盆的稳定性。[结果]39例病人无一死亡,骨折一期愈合,所有病人均未因骨盆骨折而留有并发症或重度残疾。按Matta评定标准评价疗效,治疗组优21例,良11例,中4例,差3例,优良率82.1%,而对照组优良率51.8%。差异有显著性(x2=9.16,P<0.001)。[结论]骨科损伤控制理论对于不稳定型骨盆骨折的治疗具有肯定的指导意义,骨科损伤控制应该成为不稳定型骨盆骨折治疗的临床路径。[Objective]To investigate the clinical effect of treatment guided by damage control orthopaedics（DCO）for unstable pelvic fracture. [Method]Thirty-nine cases of unstable pelvic fracture were treated under DCO.Firstly,all kinds of measures including interim simple external fixation were adopted to steady vital signs,after initial stage treatment,all patients were shifted to ICU ward for further recovery,afterwards,effective internal fixation was adopted to recover stability of pelvic fracture. [Result]Installment healing was obtained among 39 cases of patients′s fracture,and no one died.All patients had no complications and severe disability due to pelvic fracture.To evaluate the outcome according to Matta,21 excellent case,good 11case,while 4 case,poor 3 case were found.The difference with control group was statistically significant（x^2=8.34,P0.05）. [Conclusion]DCO is very significant to treatment of unstable pelvic fracture.Treatment of unstable pelvic fracture should be guided by DCO.DCO should be regarded as clinical route when unstable pelvic fracture is treated.

关 键 词：骨盆 不稳定型骨折 损伤控制 临床路径 

分 类 号：R687.3[医药卫生—骨科学]