损伤控制性外科在腹部严重创伤救治中应用体会.docVIP

损伤控制性外科在腹部严重创伤救治中应用体会【摘要】 目的 探讨损伤控制性外科(DCS)治疗严重腹部创伤的临床价值,以总结手术经验。方法 本文对2002年7月至2009年7月采用损伤控制性外科原则治疗51例严重腹部创伤患者,综合手术资料和后续治疗的情况进行回顾性分析。控制出血是DCS 的首要任务,控制污染是DCS的第2个主要目的,简化手术完成后患者送ICU,并立即开始继续复苏,所有患者72 h内均接受相应形式的再次确定性手术。结果 51例患者均经损伤控制性手术治疗。治愈42例(82.3%),再次手术术后出现腹腔脓肿2例(3.9%)、粘连性不全肠梗阻3例(5.9%),经保守治疗痊愈;死亡4例(7.8%),死亡原因与手术无明显关系。结论 符合DCS指征的严重腹部创伤的患者,应严格遵循损伤控制性外科原则,积极选择适宜的手术治疗方式,极力挽救患者生命。 【关键词】控制性外科; 损伤; 腹部 The application experience of damage control surgery in treatment of serious abdomen trauma ZHANG Yong xue,LIU Wei jun,WANG kun hua.The first People’s Hospital of Yunnan Province the general surgery department Kunming medical college affiliated Kunhua hospital Kun ming 650032,China 【Abstract】 Objective To discuss the clinical value of damage control surgery(DCS)treats the serious abdomen trauma,summarizes the surgery experience.Methods In this article from July 2002 to July 2009 we used the damage control surgical principle to treat 51 cases traumatic injury abdomen patients,the comprehensive surgery material and the following treatment?s situation carried on the review analysis.The first priority of DCS was hemorrhage control.The second purpose of DCS in first phase was contamination control Results 51 patients all apply the treatment of damage control surgery.Following the above simplified operation,patients were transferred to ICU for resuscitation.all patients accept the corresponding form once more definite surgery and had been done in 72 hours.Cures 42 cases(82.3%),after once more surgery technique,presents the abdominal cavity abscess 2 cases(3.9%),the adhesion not entire intestinal obstruction 3 cases(5.9%),after conservative treatment healing; 4 cases died(7.8%),the cause of death had nothing to do with the surgery.Conclusion Conforms to the serious abdomen wound patient who DCS refers to drafts,should choose suitable the surgery to treat the way positively,follows the damage control surgical department principle strictly,saves the patient life vigorously.