快速康复技术配合损伤控制外科技术在多发伤患者中的运用效果及影响因素分析  

The Application Effect and Influencing Factors of Rapid Rehabilitation Techniques Combined with Damage Control Surgical Techniques in Patients with Multiple Injuries

作　　者：沈蓝 陈朝明 代建能 普伦庆 王天瑞[2] 马刚 SHEN Lan;CHEN Chaoming;DAI Jianneng;PU Lunqing;WANG Tianrui;MA Gang(Trauma Center of Honghe Hospital Affiliated to Kunming Medical University/South Yunnan Central Hospital/The 1st People’s Hospital of Honghe Prefecture,Mengzi Yunnan 661199;Dept.of Orthopedics,The Affiliated Hospital of Qingdao University,Qingdao Shandong 266555;Trauma Center of The 3rd People’s Hospital of Honghe Prefecture,Gejiu Yunnan 661000,China)

机构地区：[1]昆明医科大学附属红河医院/云南省滇南中心医院/红河州第一人民医院创伤中心,云南蒙自661199 [2]青岛大学附属医院骨科,山东青岛266555 [3]红河州第三人民医院创伤中心,云南个旧661000

出　　处：《昆明医科大学学报》2024年第5期103-108,共6页Journal of Kunming Medical University

基　　金：青岛大学医疗集团科研基金资助项目(YLJT20222013);云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(202301AY070001-040)。

摘　　要：目的分析快速康复技术配合损伤控制在多发伤患者康复中的临床效果及其并发症发生情况,并探讨影响并发症发生的因素。方法收集昆明医科大学附属红河医院2020年10月至2022年11月间的108例多发伤患者临床资料,分为A组(55例)和B组(53例)。A组采用快速康复措施+损伤控制,B组采用常规康复措施+损伤控制。比较2组临床疗效、并发症发生情况及相关影响因素。结果A组在凝血功能、乳酸、体温恢复时间及术中出血量方面明显优于B组(P<0.05),而手术时间则较长(P<0.05)。A组术后ISS评分及Mb、CK、HMGB1水平均低于B组(P<0.05)。A组并发症发生率(7例)低于B组(20例)(P<0.05)。Logistic回归分析显示,治疗康复措施是影响术后并发症的主要因素。结论快速康复技术配合损伤控制治疗多发伤患者具有较好的临床效果,可明显降低术后并发症发生率,其中良好的康复治疗方式是减少并发症的关键。Objective To analyze the clinical effects of rapid rehabilitation technology combined with injury control in the rehabilitation of patients with multiple injuries and the occurrence of complications,and to explore the factors affecting the occurrence of complications.Methods The clinical data of 108 patients with multiple injuries from October 2020 to November 2022 in Honghe Hospital Affiliated to Kunming Medical University were collected and divided into group A(55 cases)and group B(53 cases).Group A was treated with rapid rehabilitation measures+injury control,group B was treated with conventional rehabilitation measures+injury control.The clinical efficacy,complications and related influencing factors were compared between the two groups.Results The blood coagulation function,lactic acid,temperature recovery time and intraoperative blood loss in group A were significantly better than those in group B(P<0.05),but the operative time was longer(P<0.05).Postoperative ISS score,Mb,CK and HMGB1 levels in group A were lower than those in group B(P<0.05).The incidence of complications in group A(7 cases)was lower than that in group B(20 cases)(P<0.05).Logistic regression analysis showed that treatment and rehabilitation measures were the main factors affecting the postoperative complications.Conclusion Rapid rehabilitation technology combined with injury control in the treatment of patients with multiple injuries has a good clinical effect and can significantly reduce the incidence of postoperative complications,among which a good rehabilitation treatment is the key to reduce complications.

关 键 词：损伤控制外科技术 快速康复技术 多发伤 效果 影响因素 

分 类 号：R641[医药卫生—外科学]