损伤控制外科在严重胸外伤为主的全身多发伤救治中的应用  

Application of Damage Control Theory for Severe Thoracic Injuries with Multiple Trauma

作　　者：何刚[1] 单远洲[2] 刘海林[1] 王洪斌[1] 姜志标 

机构地区：[1]上海交通大学附属第六人民医院南院心胸外科,上海201499 [2]上海交通大学附属第六人民医院南院普通外科,上海201499

出　　处：《现代生物医学进展》2015年第30期5858-5860,5993,共4页Progress in Modern Biomedicine

基　　金：上海市奉贤区科学技术发展基金项目(奉科20141302)

摘　　要：目的:探讨损伤控制外科(DCS)在严重胸外伤为主的全身多发伤救治中应用的临床效果。方法:2010年1月至2012年6月收治的57例患者采用早期全面治疗(ETC组),2012年7月至2013年12月收治的57例患者采用DCS理论救治(DCS组)。比较两组相关生理指标恢复情况及并发症的发生情况。结果:与ETC组比较,DCS组乳酸清除时间、体温恢复时间、PT和APTT恢复时间、住院时间、ICU治疗时间明显缩短,出血量明显减少(P<0.05);DCS组腹腔感染、ARDS、应激性溃疡的发生率及死亡率均较ETC组明显降低(P<0.05)。结论:严重胸外伤为主的全身多发伤救治中应用DCS理论可明显改善患者生理指标恢复,减少并发症,提高救治成功率。Objective： To explore the effect of damage control theory（DCS） for severe thoracic injuries with multiple trauma.Methods： 57 patients with severe thoracic injuries with multiple trauma admitted from January 2010 to June 2012 were treated with early total care（ETC group）, and another 57 patients admitted from July 2012 to December 2013 were treated with damage control theory（DCS group）. The physiological index and complications in both groups were compared. Results： Compared with ETC group, the removal time of lactic acid, temperature recovery time, PT and APTT recovery time, hospital stay, ICU treatment time were significantly shortened, and blood loss was decreased significantly in DCS group（P〈0.05）. The incidence of abdominal cavity infection, ARDS, stress ulcer and mortality of DCS group were significantly lower than those of ETC group（P〈0.05）. Conclusion： DCS for severe thoracic injuries with multiple trauma could obviously improve the recovery of physiological index, reduce the complications and improve success rate.

关 键 词：损害控制外科 多发伤 胸外伤 并发症 

分 类 号：R655[医药卫生—外科学]