骨关节型严重多发伤的院内早期救治  

Early treatment of severe polytrauma complicated by bone and joint injuries in hospital

作　　者：张旭鸣[1,2,3] 邱美光[1,2,3] 林世水[1,2,3] 庄颖峰[1,2,3] 何武兵[1,2,3] 陈曙光[1,2,3] 施爱平[1,2,3] 

机构地区：[1]福建医科大学省立临床学院 [2]福建省立医院 [3]福建省急救中心急诊外科,福建福州350001

出　　处：《创伤外科杂志》2013年第1期8-10,共3页Journal of Traumatic Surgery

摘　　要：目的探讨骨关节型严重多发伤的院内早期救治方法。方法回顾性分析我科2006年1月～2010年6月治疗骨关节损伤为主的严重多发伤73例(平均ISS≥27分)临床资料,早期采用控制出血、骨折临时固定、手术优先解决危及生命的损伤等损害控制措施救治。结果 73例患者中,1例因严重颅脑外伤死于入院后11h,1例因ARDS死于术后24h,2例因伤后第3、6天多器官功能衰竭死亡,3例因未予以早期积极救治死于入院后2h内;66例存活(90.4%),死亡7例(9.6%)。结论及时控制出血、早期骨折固定、手术优先解决危及生命的损伤、合理应用损害控制外科(damage control surgery,DCS)等措施有助于骨关节型严重多发伤的早期救治,对临床救治严重创伤伤员有很大指导意义。Objective To explore the early treatment method for bone and joint injury with severe multiple trauma in the hospital. Methods Totally 73 cases of severe multiple trauma combined with bone and joint injury （ISS≥27socres） , were admitted to our hospital from Jan. 2006 to Jun. 2010. A retrospective analysis was performed to analyze their treatments, such as timely control of bleeding, early fracture fixation, damage control surgery （ DCS） and other measurements. Results Among these 73 cases, 1 died of severe traumatic brain injury 11 hours after admission ; 1 died of ARDS 24 hours postoperatively ;2 died due to muhiple organ failure within 3 and 6 days after injury;3 died of hemorrhagic shock within 2 hours after injury due to delayed treatment. In total,66 patients sur- vived （90.4%） and 7 patients died （9.6%）. Conclusion Timely control of bleeding, early fracture fixation, priority to surgical management of life-threatening injury, a reasonable application of damage control surgery （ DCS ） and other measurements are greatly helpful in the early treatment of severe multiple bone and joint type trauma. These also have important clinical significance and are extremely recommended.

关 键 词：多发伤 骨折 早期救治 

分 类 号：R641[医药卫生—外科学]