以不稳定骨盆骨折为主的严重多发伤的救治  

Treatment of severe polytrauma dominated by unstable pelvic fractures

作　　者：邱美光[1,2] 张旭鸣[1,2] 林世水[1,2] 林昊[1,2] 施爱平[1,2] 

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

出　　处：《创伤外科杂志》2013年第3期230-232,共3页Journal of Traumatic Surgery

摘　　要：目的探讨损害控制外科理论(damage control surgery,DCS)在不稳定骨盆骨折为主的严重多发伤救治中的作用。方法回顾分析我科2006年1月～2010年12月36例不稳定骨盆骨折为主的严重多发伤患者应用DCS方法救治,第1阶段为控制出血和不稳定骨折的早期临床固定;第2阶段行ICU复苏;第3阶段行确定性手术。观察其死亡率及后遗症发生。结果 2例死亡,2例未随访,获得随访32例,随访17.6个月。1例合并胸腰椎骨折发生截瘫,3例远期出现跛行、行走痛。按Matta标准评定疗效:优19例,良10例,可3例;优良率90.6%。结论应用DCS理论救治不稳定骨盆骨折为主的严重多发伤,能明显提高其抢救成功率、减少并发症。Objective To investigate the clinical effect of damage control surgery { DCS） in treatment of se- vere polytrauma dominated by unstable pelvic fractures. Methods A retrospective study was carried out in 36 cases of unstable pelvic fractures treated by DCS from Jan. 2006 to Dec. 2010. Patients were treated by early fixation, fol- lowed by ICU resuscitation and definitive surgery. The mortality and sequela of patients were observed. Results Two patients died ,2 patients didn＇t have follow-up, and the rest 32 patients had follow-up, with an average follow-up of 17. 6 months. Paraplegia was found in 1 patient,which was caused by thoracolumbar fractures. Long-term limp and walking pain were observed in 3 patients. The curative effect was evaluated by Matta criteria, indicating excellent in 19 cases,good in 10 cases,and fair in 3 cases. Conclusion DCS for treating patients with severe polytrauma domina- ted by unstable pelvic fractures can significantly improve their success rates and reduce complications.

关 键 词：骨盆骨折 多发伤 损害控制 

分 类 号：R683.3[医药卫生—骨科学]