损伤控制理论在严重腹部外伤急救中的应用效果  

Application effect of injury control theory in emergency treatment of severe abdominal trauma

作　　者：李志鹏 袁伟忠 陈彦 LI Zhi-peng;YUAN Wei-zhong;CHEN Yan(Department of Emergency,Nanjing Meishan Hospital,Jiangsu Province,Nanjing 210000,China;Department of Emergency Center,Yifu Hospital Affiliated to Nanjing Medical University,Jiangsu Province,Nanjing 211100,China)

机构地区：[1]南京梅山医院急诊科,江苏南京210000 [2]南京医科大学附属逸夫医院急诊中心,江苏南京211100

出　　处：《中国当代医药》2019年第33期87-89,93,共4页China Modern Medicine

摘　　要：目的探讨损伤控制理论在严重腹部外伤急救中的应用效果。方法选取2015年1月~2018年1月南京梅山医院收治的194例急救治疗的严重腹部外伤患者作为研究对象,按照急诊入院的先后顺序分为常规外科救治组(97例)和损伤控制治疗组(97例)。常规外科救治组接受一般常规性腹部外伤外科处理,损伤控制治疗组给予损伤控制外科处理。比较两组的临床药物使用情况、急救治疗效果及并发症的发生情况。结果损伤控制治疗组术前浓缩红细胞悬液(CRCS)、血浆用量、补液量及羟乙基淀粉使用量低于常规外科救治组,差异均有统计学意义(P<0.05);损伤控制治疗组术后的进食时间、排气时间、抗炎时间、引流时间及住院时间短于常规外科救治组,差异均有统计学意义(P<0.05);损伤控制治疗组代谢性酸中毒、腹腔感染、腹腔间隔室综合征及体温过低的发生率低于常规外科救治组,差异均有统计学意义(P<0.05)。结论对严重腹部外伤患者应用损伤控制理论,可明显减少术前用药量,缩短康复时间,降低并发症发生率,值得临床应用推广。Objective To explore the application effect of injury control theory in emergency treatment of severe abdominal trauma.Methods A total of 194 patients with severe abdominal trauma who were received emergency treatment in Nanjing Meishan Hospital from January 2015 to January 2018 were selected as the research objects,they were divided into the conventional surgical treatment group(97 cases)and the injury control treatment group(97 cases)according to the sequence of emergency admission.The routine surgical treatment group received the general routine abdominal trauma surgical treatment,and the injury control treatment group received the injury control surgical treatment.The clinical drug use,emergency treatment effect and complications were compared between the two groups.Results The concentration red blood cell suspension(CRCS),the dosage of plasma,the dosage of rehydration and the usage of hydroxyethyl starch in the injury control group were lower than those in the conventional surgery group,the differences were statistically significant(P<0.05).The eating time,exhaust time,anti-inflammatory time,drainage time and hospitalization time in the injury control group were shorter than those in the conventional surgical treatment group,the differences were statistically significant(P<0.05).The incidence of metabolic acidosis,abdominal infection,abdominal compartment syndrome and hypothermia in the injury control group were lower than those in the conventional surgical treatment group,the differences were statistically significant(P<0.05).Conclusion The application of damage control theory to patients with severe abdominal trauma can significantly reduce the dosage before operation,shorten the rehabilitation time and reduce the incidence of complications,which is worthy of clinical application.

关 键 词：腹部外伤 损伤控制 急救医学 临床效果 

分 类 号：R572[医药卫生—消化系统]