损伤控制外科理念在严重多发伤抢救中的临床应用  

Curative efficacy of damage control surgery in the treatment of multiple injuries in emergency surgery

作　　者：蔡伟俊 谢扬[1] 黄铿[1] CAIWei-jun;XIE Yang;HUANG Keng(Emergency Department,Second Affiliated Hospital of Shantou University Medical College,Shantou 515000,Guangdong,CHINA)

机构地区：[1]汕头大学医学院第二附属医院急诊科,广东汕头515000

出　　处：《海南医学》2020年第9期1125-1127,共3页Hainan Medical Journal

摘　　要：目的研究损伤控制外科(DCS)理念应用于严重多发伤抢救的临床效果。方法选择2016年5月至2018年5月汕头大学医学院第二附属医院接诊的急诊外科多发伤患者160例作为研究对象,采用随机数表法将患者分为对照组和观察组,每组80例,对照组给予常规方式救治,观察组给予DCS技术。比较两组患者的抢救成功率、血管内凝血发生情况、手术时间、出血量、重症监护室(ICU)停留时间、住院时间、体温恢复时间、乳酸恢复时间、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、血液碱剩余(BE)及并发症发生情况。结果治疗后,观察组患者的抢救成功率91.25%,明显高于对照组的66.25%;血管内凝血发生率为6.25%,明显低于对照组的26.25%,差异均具有统计学意义(P<0.05);观察组患者的手术时间为(192.79±35.46)min,明显长于对照组的(171.61±35.14)mim,出血量为(1987.35±434.36)mL,明显低于对照组的(2389.54±502.16)mL,差异均具有统计学意义(P<0.05);观察组和对照组患者体温恢复时间[(8.91±1.46)h vs(18.87±1.99)h]、乳酸恢复时间[(11.52±6.27)h vs(32.34±8.37)h]、APTT和PT恢复时间[(12.45±5.46)h vs(29.42±16.23)h]、BE恢复时间[(14.31±4.35)h vs(29.39±5.87)h]、ICU停留时间[(7.13±1.54)d vs(11.52±4.12)d]、住院时间[(78.14±25.34)d vs(95.46±30.41)d]比较,观察组明显快于或少于对照组,差异均具有统计学意义(P<0.05);观察组患者的并发症总发生率为16.25%,明显低于对照组的43.75%,差异有统计学意义(P<0.05)。结论在急诊外科多发伤救治中应用DCS技术可有效提高患者的抢救成功率、降低并发症发生率和减少患者住院时间。Objective To study the clinical effect of the application of damage control surgery(DCS)in the rescue of severe multiple injuries.Methods A total of 160 patients with multiple injuries in emergency surgery received by the Second Affiliated Hospital of Shantou University Medical College from May 2016 to May 2018 were selected as the study objects.The patients were divided into control group and observation group by random number table method,with 80 patients in each group.The control group was given routine treatment,and the observation group was given DCS technology.The success rate of rescue,the occurrence of intravascular coagulation,operation time,bleeding volume,ICU stay time,length of hospital stay,body temperature recovery time,lactate recovery time,prothrombin time(PT),activated partial prothrombin time(APTT),blood base surplus(BE),and complications were compared between the two groups.Results After treatment,the success rate of rescue in the observation group was 91.25%,significantly higher than 66.25%in the control group(P<0.05);the incidence of intravascular coagulation was 6.25%,significantly lower than 26.25%in the control group(P<0.05);the operation time of the observation group was(192.79±35.46)min,which was significantly longer than(171.61±35.14)mm of the control group;the bleeding volume was(1987.35±434.36)mL,which was significantly lower than(2389.54±502.16)mL of the control group(P<0.05).The observation group also had significantly lower body temperature recovery time with(8.91±1.46)h vs(18.87±1.99)h,lactate recovery time with(11.52±6.27)h vs(32.34±8.37)h,APTT and PT recovery time with(12.45±5.46)h vs(29.42±16.23)h,BE recovery time with(14.31±4.35)h vs(29.39±5.87)h,ICU stay with(7.13±1.54)d vs(11.52±4.12)d,and length of hospital stay with(78.14±25.34)d vs(95.46±30.41)d(P<0.05).The total incidence of complications in the observation group was 16.25%,which was significantly lower than 43.75%in the control group(P<0.05).Conclusion The application of DCS in the treatment of multiple

关 键 词：多发伤 损伤控制外科 急诊 应用效果 

分 类 号：R641[医药卫生—外科学]