损伤控制性外科理论在合并腹部创伤的严重多发伤的应用分析被引量：15

Application of damage control surgery in treatment of patients with abdominal trauma and severe multiple injuries

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摘要目的探讨损伤控制性外科理论在合并腹部创伤的严重多发伤中的临床应用。方法回顾性分析2009年1月-2012年12月4年来本院就诊的合并腹部创伤的老年患者60例，所有患者根据预后分为死亡组（n=10）和存活组（n=50），入选患者按ISS评分分为3组：A组（n=25）16-24分、B组（n=23）25～34分、C组（n=12）〉35分，观察死亡和存活患者的颅脑损伤例数、ISS平均值和并发症例数，ISS评分与损伤部位数、手术部位数、确定性手术时间、输血量、住院时间、并发症和死亡率的关系。结果死亡组和存活组患者出现颅脑损伤和并发症例数比较差异有统计学意义（P〈0．05）；ISS评分平均值分别比较差异也有统计学意义（P〈0．01）。A、B和C3组ISS评分相比差异有统计学意义（P〈0．01）；3组确定性手术时间、输血量、住院时间随着ISS评分增加而明显增加，差异有统计学意义（P〈0．01）；3组出现并发症和死亡例数比较差异有统计学意义（P〈0．05）。结论ISS评分能对临床合并腹部损伤的多发伤患者的病情进行评估，并能指导治疗和评估预后，损伤控制性手术能明显降低老年创伤患者的术后并发症率和死亡率，改善患者预后。 Objective To explore role of damage control surgery in the treatment of patients with abdominal trauma and severe multiple injuries. Methods 60 elderly patients with abdominal trauma were collected and divided into death group （n = 10） and survival group （n =50） according to the prognosis. According to the ISS score, patients were divided into group A （n = 25, 16 to 24 points）, group B （n =23, 25 to 34 points）and group C （n = 12, 〉35 points）. Death and survival cases in patients with craniocerebral injury, mean ISS value and complications, ISS score and the number of injury, surgical site number, deterministic operation time, blood transfusion amount, length of hospital stay, the relationship between complications and mortality were observed in both groups. Results There were significant differences of craniocerebral injury and complications in death and survival group （P 〈 0.05）. There were significant differences of ISS score in group A, group B and group C （ P 〈 0.01 ）. Operation time, blood transfusion amount, length of hospital stay increased with the increasing of ISS score （ P 〈 0.01 ）. There were significant differences of complications and death cases in group A, group B and group C （P 〈 0.05）. Conclusion ISS score can guide therapy and evaluate prognosis, and damage control surgery can significantly reduce the postoperative incidence rate of complications and mortality in elderly patients with trauma.

作者谢玉宏

机构地区湖北省襄阳市第一人民医院急诊科

出处《实用临床医药杂志》 CAS 2014年第5期45-47,共3页 Journal of Clinical Medicine in Practice

关键词腹部创伤严重多发伤损伤控制 abdominal trauma severe multiple injury damage control

分类号 R641 [医药卫生—外科学]

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