损伤控制性手术在野战条件下腹部严重创伤治疗中的应用价值  

Clinical Value of the Damage Control Operation Applied to the Traumatic Surgery in the CS

作　　者：余灵祥[1] 张绍庚[1] 郭晓东[2] 肖朝辉[1] 凌海慧[3] 赵德希[1] 吴建中[1] 张培瑞[1] 李志伟[1] 

机构地区：[1]解放军第302医院肝胆外科一中心,北京100039 [2]解放军第302医院病理诊断与研究中心,北京100039 [3]解放军第302医院药学研究中心,北京100039

出　　处：《现代生物医学进展》2014年第21期4060-4062,共3页Progress in Modern Biomedicine

基　　金：北京市科技计划首都临床特色应用研究专项(Z131100004013041);解放军第302医院院内课题(YNKT2013018)

摘　　要：目的:损伤控制性手术(Damage Control Operation,DCO)是针对严重创伤患者进行阶段性修复的外科策略,本文通过观察DCO在野战条件下严重腹部创伤治疗中的效果,探讨其应用价值,为野战外科手术提供参考。方法:对2012年2月-2013年3月我院收治的90例重症肝胆外伤患者的临床资料进行回顾性分析。将所选病例随机分为对照组和DCO组,每组45例。其中对照组实施常规手术治疗,DCO组实施损伤控制性手术进行治疗。对比两组患者的手术时间,术中出血量、死亡率、术后感染及并发症等。结果:DOC组手术时间为(62.59±8.61)min,术中出血量为(306.48±23.54)mL,死亡率为20%,术后感染率为8.89%,并发症的发生率为11.11%;对照组术时间为(90.35±7.86)min,术中出血量为(600.32±34.21)mL,死亡率为53.33%,术后感染率为24.44%,并发症的发生率为35.56%;DCO组患者的各项指标均优于对照组,差异显著且具有统计学意义(P<0.05)。结论:在肝胆外科治疗中采用损伤控制性手术具有明显的临床效果,不但缩短了手术时间,减少出血量,提高手术成功率,而且降低了术后并发症的发生率,值得推广。Objective： The damage control operation is a clinical strategy which is devoted to reconstructing the open injuries of patients for a period of time. This article aims to observe the application value of damage control operation on the hepatobiliary surgery in order to make a reference to clinical. Methods： A retrospective analysis was performed about the clinical data of 90 patients with severe liver injury who were treated in our hospital from February 2012 to March 2013. The selected patients were divided into the control group and the DCO group with 45 in each one. The patients in the control group were received the routine operation method, while the patients in the DCO group were treated by the damage control operation. Then the operation time, the blood loss, the rate of death, the incidence of infection and complications after the operation were compared and analyzed between two groups. Results： In the DCO group, the operation time was（62.59± 8.61） min, the blood loss was（306.48± 23.54） mL, the death rate was 20%, the infection rate was 8.89% and the incidence of complications was 11.11%; In the control group, the operation time was （90.35± 7.86） min, the blood loss was （600.32± 34.21） mL, the death rate was 53.33%, the infection rate was 24.44% and the incidence of complications was 35.56%; The indicators of the DCO group were significantly better than those of the control group with statistically significant differences（P〈0.05）. Conclusions： The damage control operation is worthy of promoting to the clinical field with the advantages of obvious efficacy, shorter time for operation, less blood loss, higher rate of success as well as the lower incidence of infection and complications after the surgeries.

关 键 词：腹部创伤 损伤控制 野战外科 应用价值 

分 类 号：R657.3[医药卫生—外科学]