损伤控制外科技术在急诊科外科多发伤救治中应用.docVIP

损伤控制外科技术在急诊科外科多发伤救治中应用[摘要] 目的 探讨损伤控制外科技术抢救急诊科外科多发伤患者的临床效果。方法 对46例多发伤患者采取损伤控制的效果进行回顾性分析，并选出病情严重程度一致、以传统方式抢救的多发伤患者46例，比较两组患者乳酸和体温恢复时间、PT和ATT及BE恢复时间、手术时间、出血量、DIC发生率、并发症发生率及死亡率。结果 治疗组患者乳酸恢复时间、体温恢复时间、PT和ATT及BE恢复时间、出血量均明显小于对照组，差异有显著的统计学意义（P＜0.01），治疗组患者DIC发生率、其他并发症发生率、死亡率明显少于对照组，差异有显著的统计学意义（P＜0.01或P＜0.05），而两组手术时间差异无明显的统计学意义。结论 在多发伤中运用损伤控制能明显提高严重创伤的生存率，降低并发症的发生，值得临床广泛推广应用。 [关键词] 损伤控制外科技术；多发伤；死亡率；并发症 [中图分类号] R641 [文献标识码] B [文章编号] 1673-9701（2011）22-156-02 Application of Damage Control Surgery in Severe Multiple Injury Associated in Emergency Department PAN Guanghua XU Qingyu ZHENG Xudong CHEN Chunbai WU Haibin Emergency Center of Ruian People’s Hospital in Zhejiang Province，Ruian 325200， China [Abstract] Objective To explore the therapeutical effect of damage control surgery formultiple injury in emergency department. Methods All 46 patients with multiple injury were received damage control surgery. Other 46 patients with similar clinical characteristics treated with conventional therapy. Compared with recovery time of body temperature，PT and ATT，BE recovery time，clearance time of lactic acid，incidence of diffuse intravascular coagulation and mortality in two groups. Results Recovery time in patients treated with lactate，body temperature recovery time，PT，ATT recovery time， BE recovery time and bleeding were significantly lower than those in the control group，the difference were statistical significances（P＜0.01）；treatment group，the incidence of DIC patients，other complication rate and mortality rate were significantly less than those in the control group，the difference were statistical significance（P＜0.01 or P＜0.05）；No difference in hospitalization time the two groups statistically significant. Conclusion Damage control surgery can improve therapeutic efficacy of patients with multiple injury，worthy to be wide in clinical. [Key words] Damage control surgery；Multiple injury；Death rate；Complication 创伤是当今人类死亡的最主要原因之一，随着近年来高速公路及机动车辆的普及、建筑物的不断增高、化工爆炸、矿井塌方及地震