伤害控制骨科学原则在严重多发创伤中的应用.pdfVIP

2542 重庆医学 2009 年 10 月第 38 卷第 20 期 ·临床研究· 伤害控制骨科学原则在严重多发创伤中的应用 蒋涛，彭加英，冯敬 (四川省绵阳市第三人民医院骨科 621000) 摘 要:目的 探讨伤害控制骨科学(DCO)在严重多发创伤合并多处骨折患者救治中的临床应用。方法 对 2006 年 3 月至 2009 年 3 月收治的以 oco 原则处理的 35 例严重多发创伤合并多处骨折患者的临床资料进行分析。结果 患者损伤包括四肢 骨千骨折、骨盆骨折、脊柱骨折及颅脑、胸腹部等其他系统损伤，乎均损伤严重程度许分ClSS) =28.7 土3.2 分，格拉斯哥昏迷仔分 (GCS) =9. 2 土2.1 分。死亡 1 例，大腿截肢 2 例，腔骨骨折发生不愈合 2 例，经再次手术最后愈合;其余 30 例骨折愈合，未出现严 重并发症，肢体功能恢复满意。 35 例中 28 例患者重新回到以前的工作岗位。结论 对严重多发伤合并多发性骨折患者使用伤 害控制策略治疗，争取尽快恢复患者体能，降低手术风险，从而减少后遗症和并发症的发生，可改善患者预后。 关键词:伤害控制:多发伤 g 骨折:应用 中图分类号:R641 ;R683 文献标识码:A 文章编号: 1671-8348(2009)20-2542-02 Application or treatment in multiple traumas witb multiple fractures by damage control ortbo阴对iαstrategy J IANG Tao .PENG Jia-ying .FENG Jing .et al. (Department of Orthopaedics .the Third Hosρital of Mianyang .Sichzωn 621000.China) Abstract:Objective To discuss the clinical application and results of the damage control orthopedics strategy in the treatment of multiple traumas combined with bone injury. 岛1.ethods Analysis was performed on 35 cases of patients from March 2006 to March 2009. whom with severe multiple traumas we treated with DCO strategy in our department. Results Patients damage indud- ed limb fractures.pelvic fractures.spine fractures and other system damag.such as craniocerebral and chest damag.and average ISS score was 28. 7. GCS was 9. 2. One death .leg amputation in 2 cases. tibia ÍTactures occur nonunion in 2 cases. but both were he喧ling by reoperation in the end.and the rest of 30 cases were healing.no serious complications.limb function recovered satisfactorily. In a11 cases. twenty-eight patients went back to the previous jobs. Conclusion Using damage control strategy in severe mult