损伤控制性手术在野战条件下腹部严重创伤治疗中的应用价值

目的:损伤控制性手术(Damage Control Operation,DCO)是针对严重创伤患者进行阶段性修复的外科策略,本文通过观察DCO在野战条件下严重腹部创伤治疗中的效果,探讨其应用价值,为野战外科手术提供参考。方法:对2012年2月-2013年3月我院收治的90例重症肝胆外伤患者的临床资料进行回顾性分析。将所选病例随机分为对照组和DCO组,每组45例。其中对照组实施常规手术治疗,DCO组实施损伤控制性手术进行治疗。对比两组患者的手术时间,术中出血量、死亡率、术后感染及并发症等。结果:DOC组手术时间为(62.59±8.61)min,术中出血量为(306.48±23.54)mL,死亡率为20%,术后感染率为8.89%,并发症的发生率为11.11%;对照组术时间为(90.35±7.86)min,术中出血量为(600.32±34.21)mL,死亡率为53.33%,术后感染率为24.44%,并发症的发生率为35.56%;DCO组患者的各项指标均优于对照组,差异显著且具有统计学意义(P0.05)。结论:在肝胆外科治疗中采用损伤控制性手术具有明显的临床效果,不但缩短了手术时间,减少出血量,提高手术成功率,而且降低了术后并发症的发生率,值得推广。

Clinical Value of the Damage Control Operation Applied to the TraumaticSurgery in the CS

Objective:The damage control operation is a clinical strategy which is devoted to reconstructing the open injuries ofpatients for a period of time. This article aims to observe the application value of damage control operation on the hepatobiliary surgery inorder to make a reference to clinical.Methods:A retrospective analysis was performed about the clinical data of 90 patients with severeliver injury who were treated in our hospital from February 2012 to March 2013. The selected patients were divided into the controlgroup and the DCO group with 45 in each one. The patients in the control group were received the routine operation method, while thepatients in the DCO group were treated by the damage control operation. Then the operation time, the blood loss, the rate of death, theincidence of infection and complications after the operation were compared and analyzed between two groups.Results:In the DCOgroup, the operation time was(62.59± 8.61) min, the blood loss was(306.48± 23.54) mL, the death rate was 20%, the infection rate was8.89% and the incidence of complications was 11.11%; In the control group, the operation time was (90.35± 7.86) min, the blood losswas (600.32± 34.21) mL, the death rate was 53.33%, the infection rate was 24.44%and the incidence of complications was 35.56%; Theindicators of the DCO group were significantly better than those of the control group with statistically significant differences(P<0.05).Conclusion:The damage control operation is worthy of promoting to the clinical field with the advantages of obvious efficacy, shortertime for operation, less blood loss, higher rate of success as well as the lower incidence of infection and complications after the surgeries.