损伤控制骨科技术在骨折合并严重多发伤治疗中的可行性探讨

发布时间：2018-04-26 09:47

本文选题：多发创伤 + 骨折　；参考：《重庆医学》2017年19期

【摘要】：目的探讨损伤控制骨科(DCO)技术在骨折合并严重多发伤治疗中的可行性。方法收集2014年5月至2016年8月于东莞市大朗医院治疗的124例骨折合并严重多发伤患者的临床资料,均行DCO治疗,观察临床治疗结局及并发症发生情况,比较治疗前后各项生理指标及损伤严重度评分(ISS)。结果 124例患者经DCO治疗后,120例(96.77%)存活,4例(3.23%)死亡。120例存活者并发症发生率为5.83%,其中急性呼吸窘迫综合征(ARDS)1例、弥漫性血管内凝血(DIC)2例、肺部感染1例、血栓2例、膈下脓肿1例。术后pH、体温、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、白细胞介素-6(IL-6)等生理指标较术前均明显改善,且ISS评分较术前降低,差异均有统计学意义(P0.05)。结论在骨折合并严重多发伤的治疗中应用DCO技术能有效控制患者生命体征的稳定性,提高救治率,降低死亡风险,减少并发症,减轻创伤程度。
[Abstract]:Objective to investigate the feasibility of DCO-injury control technique in the treatment of fracture with severe multiple injuries. Methods from May 2014 to August 2016, the clinical data of 124 patients with severe multiple fractures and multiple injuries were collected from Dalong Hospital of Dongguan City. All patients were treated with DCO, and the clinical outcome and complications were observed. The scores of physiological indexes and injury severity before and after treatment were compared. Results the incidence of complications in 120 patients with acute respiratory distress syndrome (ARDS), diffuse intravascular coagulation (DCO), pulmonary infection (1 case), thrombus (2 cases), pulmonary infection (1 case) and thrombus (2 cases) were 5.83%. One case of subphrenic abscess. The physiological indexes such as pH, body temperature, prothrombin time, activated partial thromboplastin time (APTTT) and interleukin-6 (IL-6) were significantly improved after operation, and the ISS score was lower than that before operation (P 0.05). Conclusion DCO technique can effectively control the stability of vital signs, improve the treatment rate, reduce the risk of death, reduce complications and reduce the degree of trauma in the treatment of fractures with severe multiple injuries.
【作者单位】：广东省东莞市大朗医院骨科;重庆市东南医院骨科;
【分类号】：R683

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