损害控制外科在严重多发伤合并休克救治中的应用  

The application of damage control surgery in the treatment of severe multiple injury with shock

作　　者：马民[1] 翟春霞[1] 

机构地区：[1]山东省莱芜市人民医院急诊科,山东莱芜271100

出　　处：《现代仪器与医疗》2017年第5期6-7,10,共3页Modern Instruments & Medical Treatment

摘　　要：目的:分析损害控制外科(Damage control surgery,DCS)在严重多发伤合并休克救治中的应用价值。方法:按照入院时间,将2013年2月—2015年1月入院接受传统救治的94例患者纳入对照组,将2015年2月—2017年2月入院实施DCS救治的101例患者纳入DCS组,比较两组患者治疗情况、手术情况、生理指标恢复时间、并发症发生率、病死率。结果:DCS组24 h输注晶体液量、胶体液量及浓缩红细胞量低于对照组,其输注血浆量高于对照组,住院时间低于对照组、手术时间长于对照组,差异有统计学意义(P<0.05)。两组术中平均体温比较,差异无统计学意义(P>0.05)。DCS组各项在生理指标恢复时间均短于对照组,差异有统计学意义(P<0.05)。DCS组患者并发症发生率及病死率均低于对照组,差异有统计学意义(P<0.05)。结论:在严重多发伤合并休克的救治中,遵循DCS理念能够有效纠正内环境紊乱、促进生理指标恢复,降低患者并发症发生率及病死率,达到良好的救治效果。Objective：The objective of this study was to investigate the therapeutic effect of damage control surgery in severe multiple injury with shock.Methods：A total of 94 cases of patients provided with traditional treatment between February 2013 and January 2015 were divided into observation group,while 101 patients treated with DCS between February 2015 and February 2017 were divided into DCS group.The treatment,operation situation,time taken to recover the physical signs,the occurrence rate of complication and the morbidity rate of two groups were compared.Results：The volume of crystalline solution injection,colloidal solution injection and concentrated red blood cells during 24 hours of DCS group were lower than that of observation group,while the volume of plasma injection was higher than that of observation group and the length of hospitalization was shorter than that of observation group and the length of operation was longer than that of observation group,and the differences were statistically significant（P〈0.05）.The difference of average body temperature during operation between two groups was not statistically significant（P〉0.05）.The time taken to recover the various physical signs of DCS group was shorter than that of observation group and the difference was statistically significant（P〈0.05）.Conclusions：Applying the concept of DCS in the treatment of severe multiple injury with shock can improve internal circulation and the recovery of physical signs,which reduces the rate of complications and morbidity.

关 键 词：损害控制外科 严重多发伤 休克 

分 类 号：R605.97[医药卫生—急诊医学]