摘要
目的探讨损伤控制性手术在边界型严重多发性骨折治疗中的疗效。方法选择2009年1月-2010年6月应用外科手术救治的严重多发性骨折37例患者（ISS16～42分，Pape分型为边界型）。全部患者按损伤控制原则实施分期手术治疗，第一阶段予以止血、清创和骨折的临时固定，第二阶段主要为抗休克、抗凝血功能异常、抗低温和抗感染等治疗，在生理情况允许后再尽早行第三阶段的骨折确定性手术。结果所有患者经第一和第二阶段治疗后均实现了有效的清创、固定和抗休克治疗，未发生医源性二次损伤。确定性手术后患者恢复良好，术后随访6—14个月，总致残率为16％。结论采用损伤控制理念分期手术治疗边界型严重多发性骨折安全有效。
Objective To investigate the curative effects of damage control surgery in treatment of borderline severe multiple fractures. Methods The study involved 37 patients with severe multiple fractures （ISS of 16-42, Pape classification of borderline type） surgically treated from January 2009 to June 2010. All patients underwent staged surgeries according to damage control principles： hemostasis, debridement and provisional fixation were given in the first stage ; antishock, anti-coagulation dysfunction, anti-hypothermy, anti-infection were performed in the second stage; definitive operations for fractures were performed as soon as possible in the third stage, provided that their physiological condition was per- mitted. Results All the patients received effective treatments such as debridement, provisional fixation and antishock in the first and second stages, with no iatrogenic secondary injury. The patients had signifi- cant recovery in the 6-14 months of follow-up, with total disability rate of 16%. Conclusion The staged operations according to damage control principles are effective and safe in treatment of borderline severe multiple fractures.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2012年第11期1022-1025,共4页
Chinese Journal of Trauma
关键词
骨折
多处创伤
损伤严重评分
损伤控制
Fractures
Multiple trauma
Injury severity score
Damage control
