骨盆骨折院前急救和院内救治的损伤控制效果  

Effect of injury control in pre-hospital first aid and in-hospital treatment for pelvic fractures

作　　者：曾贤梁[1] 李王安[1] 施志国[1] 陈仪[1] 林才[1] 陈创造 ZENG Xian-liang;LI Wang-an;SHI Zhi-guo;CHEN Yi;LIN Cai;CHEN Chuang-zao(Emergency Surgery Department,Huizhou First People's Hospital,Huizhou 516000,China)

机构地区：[1]惠州市第一人民医院急诊外科,广东惠州516000

出　　处：《临床医学研究与实践》2020年第16期45-46,49,共3页Clinical Research and Practice

基　　金：2016年惠州市社会发展与公益研究项目(No.20161202111905)。

摘　　要：目的探究骨盆骨折院前急救和院内救治的损伤控制效果。方法择取2016年11月至2019年12月我院收治的经急诊CT检查确诊的101例骨盆骨折患者为观察组,另回顾性分析2012年1月至2016年10月157例骨盆骨折患者的临床资料,并将其设为对照组。观察组根据骨科损伤控制(DCO)理论开展对应治疗,对照组行常规院前急救和院内救治。比较两组死亡率、并发症发生情况、实验室指标、骨折复位效果及远期疗效。结果观察组患者死亡率低于对照组,骨折复位优良率和Cole评分高于对照组,差异具有统计学意义(P<0.05)。观察组感染、DIC及MODS发生率均低于对照组,差异具有统计学意义(P<0.05)。复苏4 h后,观察组PT短于对照组,HCT、PLT高于对照组,血乳酸含量低于对照组,差异具有统计学意义(P<0.05)。结论在骨盆骨折患者的院前急救、院内救治中开展DCO理论能有效提升救治效果,降低患者并发症发生率及死亡率,值得在临床中推广。Objective To investigate the effect of injury control in pre-hospital first aid and in-hospital treatment for pelvic fractures.Methods A total of 101 patients with pelvic fractures admitted in our hospital who were diagnosed by emergency CT examination from November 2016 to December 2019 were selected and set as observation group,and the clinical data of 157 patients with pelvic fractures from January 2012 to October 2016 were analyzed retrospectively and set as control group.The observation group carried out corresponding treatment according to theory of damage control in orthopedics(DCO),the control group received routine pre-hospital first aid and in-hospital treatment.The mortality,complications,laboratory indexes,fracture reduction effect and long-term effects of the two groups were compared.Results The mortality of the observation group was lower than that of the control group,and the excellent and good rate of fracture reduction and Cole score were higher than those of the control group,the differences were statistically significant(P<0.05).The incidences of infection,DIC and MODS in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 4 h of resuscitation,PT in the observation group was shorter than that in the control group,HCT and PLT were higher than those in the control group,and the blood lactate content was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion DCO theory in pre-hospital first aid and in-hospital treatment can effectively improve the treatment effect and reduce the incidences of complications and mortality of patients with pelvic fracture,which is worth promoting in clinic.

关 键 词：骨盆骨折 院前急救 院内救治 损伤控制 

分 类 号：R683.3[医药卫生—骨科学]