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老年重度骨盆骨折的救治 被引量:2

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摘要 目的探讨老年重度骨盆骨折损伤控制复苏(damage contra lresuscitation,DCIR)的临床疗效。方法回顾性分析2012年1月-2015年12月间北京市顺义区医院收治的32例老年重度骨盆骨折患者的临床资料。其中男21例,女11例;年龄60~78岁,平均68.5岁。采州损伤控制手术的同时应用恰当的DCR策略救治。即入院时迅速采用小容量液体(等渗盐水或平衡盐液及浓缩红细胞、血浆等胶体液)维持收缩压80~90mmHg,同时急诊行外闻定支架或骨盆束缚带加骨牵引固定骨盆,优先处珲胸腹部合并伤。手术控制出血后快速窬踺复苏、21例生命体征平稳后(伤后72h内)即尽赶采用做创手术方式行骨盆骨折内定手术治疗。结果5例入院后(〈24h)抢救几效死亡(严重创伤失血性休克3例,急性呼吸窘迫综合征2例)。27例休克均在伤后24,48h得到纠正,21例均在伤后72h内完成骨盆骨折确定性手术,复苏成功率84.4%(27/32)。结论老年重度骨盆骨折的救治应采取恰当及时的损伤控制原则及合理的微创技术,尽早完成骨盆骨折的内吲定手术,可迅速有效地挽救患者生命,减少并发症的发生牢,提高患者的生存率。
作者 芦志英
出处 《中国急救复苏与灾害医学杂志》 2017年第4期396-397,共2页 China Journal of Emergency Resuscitation and Disaster Medicine
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