损伤控制外科在严重胸外伤为主的全身多发伤救治中的应用

目的:探讨损伤控制外科(DCS)在严重胸外伤为主的全身多发伤救治中应用的临床效果。方法:2010年1月至2012年6月收治的57例患者采用早期全面治疗(ETC组),2012年7月至2013年12月收治的57例患者采用DCS理论救治(DCS组)。比较两组相关生理指标恢复情况及并发症的发生情况。结果:与ETC组比较,DCS组乳酸清除时间、体温恢复时间、PT和APTT恢复时间、住院时间、ICU治疗时间明显缩短,出血量明显减少(P0.05);DCS组腹腔感染、ARDS、应激性溃疡的发生率及死亡率均较ETC组明显降低(P0.05)。结论:严重胸外伤为主的全身多发伤救治中应用DCS理论可明显改善患者生理指标恢复,减少并发症,提高救治成功率。

Application of Damage Control Theory for Severe Thoracic Injuries withMultiple Trauma

Objective:To explore the effect of damage control theory (DCS) for severe thoracic injuries with multiple trauma.Methods:57 patients with severe thoracic injuries with multiple trauma admitted from January 2010 to June 2012 were treated with earlytotal care (ETC group), and another 57 patients admitted from July 2012 to December 2013 were treated with damage control theory(DCS group). The physiological index and complications in both groups were compared.Results:Compared with ETC group, theremoval time of lactic acid, temperature recovery time, PT and APTT recovery time, hospital stay, ICU treatment time were significantlyshortened, and blood loss was decreased significantly in DCS group (P<0.05). The incidence of abdominal cavity infection, ARDS, stressulcer and mortality of DCS group were significantly lower than those of ETC group (P<0.05).Conclusion:DCS for severe thoracicinjuries with multiple trauma could obviously improve the recovery of physiological index, reduce the complications and improve successrate.