损伤控制性手术用于急诊重症腹部外伤患者的体会  

Experience of damage control surgery in emergency patients with severe abdominal trauma

作　　者：徐永恒 XU Yong-heng(Department of Emergency,Guangzhou Hospital of Integrated Traditional and Western Medicine,Guangzhou 510800,China)

机构地区：[1]广州市中西医结合医院急诊科,广州510800

出　　处：《医师在线》2024年第10期51-53,共3页Journal of Doctors Online

摘　　要：目的分析损伤控制性手术(DCS)在急诊重症腹部外伤患者中的应用效果。方法选取2019年1月~2023年1月广州市中西医结合医院收治的83例急诊重症腹部外伤患者作为研究对象,根据不同治疗措施分为传统组(n=41)与观察组(n=42)。传统组以传统急诊手术方式治疗,观察组采取DCS治疗,比较两组患者术后临床指标改善情况[体温恢复时间、乳酸清除时间、活化部分凝血活酶时间(APTT)恢复时间]、死亡率、并发症发生情况等。结果治疗后,观察组体温恢复时间、乳酸清除时间、APTT恢复时间均短于传统组,两组比较差异具有统计学意义(P<0.01)。治疗后,两组急性生理功能与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分均降低,观察组APACHEⅡ评分显著低于传统组,差异具有统计学意义(P<0.01)。观察组死亡率及腹腔感染、肺部感染、肠梗阻等并发症发生率均低于传统组,差异具有统计学意义(P<0.05)。两组切口感染发生率比较,差异无统计学意义(P>0.05)。结论DCS在急诊重症腹部外伤患者中的应用效果满意,有利于挽救患者生命,降低并发症发生几率和死亡率。Objective To analyze the application effect of damage control surgery(DCS)in emergency patients with severe abdominal trauma.Methods A total of 83 emergency patients with severe abdominal trauma admitted to Guangzhou Hospital of Integrated Traditional and Western Medicine from January 2019 to January 2023 were selected as the research objects.According to different treatment measures,they were divided into traditional group(n=41)and observation group(n=42).The traditional group was treated with traditional emergency surgery,and the observation group was treated with DCS.The improvement of postoperative clinical indicators[body temperature recovery time,lactic acid clearance time,activated partial thromboplastin time(APTT)recovery time],mortality rate and the incidence of complications were compared between the two groups.Results After treatment,the temperature recovery time,lactic acid clearance time and APTT recovery time in observation group were shorter than those in the traditional group,and the difference between the two groups was statistically significant(P<0.01).After treatment,the acute physiology and chronic health evaluation II(APACHEⅡ)scores of the two groups decreased,the APACHE II score in the observation group was significantly lower than that in the traditional group,and the difference was statistically significant(P<0.01).The mortality rate and the incidence of complications such as abdominal infection,pulmonary infection and intestinal obstruction in the observation group were lower than those in the traditional group,and the difference were statistically significant(P<0.05).There was no significant difference in the incidence of incision infection between the two groups(P>0.05).Conclusion The application effect of DCS in emergency patients with severe abdominal trauma is satisfactory,which is conducive to saving patients'lives,reducing the incidence of complications and mortality.

关 键 词：急诊 重症腹部外伤 损伤控制性手术 体会 

分 类 号：R656[医药卫生—外科学]