损害控制救治平时和地震时严重多发伤的比较研究
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摘要
目的:探讨损害控制在平时和地震时救治严重多发伤的作用。方法:回顾性对比研究损害控制技术救治平时骨关节型严重多发伤26例和汶川地震时骨关节型严重多发伤24例,评估两组伤员的病情特点、损害控制救治方法及临床效果。结果:平时组26例全部存活,19例返回原工作岗位,7例生活自理,其中3例需继续治疗。地震组24例全部存活,4例重要器官衰竭者已脱离危险,3例尚需进一步的清创和植皮手术,其他伤员均已完成确定性手术并顺利康复之中。损害控制技术救治平时组和地震组严重多发伤,两者救治效果差异没有统计学意义(P>0.05)。结论:骨科损害控制技术救治平时和地震时严重多发伤均可取得理想效果。
Objective:To compare the outcome of damage control in patients with severe polytrauma in normal time and in the earthquake of 2008 Sichuan China.Methods:In the retrospective study,26 cases with severity polytrauma in peacetime and 24 cases with severe polytrauma who have mainly sustained in the earthquake of 2008 Sichuan China were involovd.The patients' demographics,the methods and effects of damage control were evaluated.Results:In the earthquake group,24 cases succeeded in the rescuing life;among whom,3 patients needed the further debridement and dermoplasty.In the normal time group,26 cases succeeded in the rescuing life;among whom,19 patients had returned to their former work and 3 patients need-ed the further treatment.There was no difference between two groups in therapeutic effects(P>0.05).Conclusion:Both in earthquake and in normal time,treating the severity polytrauma by damage control orthopedics can acquire satisfied effect.
Objective:To compare the outcome of damage control in patients with severe polytrauma in normal time and in the earthquake of 2008 Sichuan China.Methods:In the retrospective study,26 cases with severity polytrauma in peacetime and 24 cases with severe polytrauma who have mainly sustained in the earthquake of 2008 Sichuan China were involovd.The patients' demographics,the methods and effects of damage control were evaluated.Results:In the earthquake group,24 cases succeeded in the rescuing life;among whom,3 patients needed the further debridement and dermoplasty.In the normal time group,26 cases succeeded in the rescuing life;among whom,19 patients had returned to their former work and 3 patients need-ed the further treatment.There was no difference between two groups in therapeutic effects(P>0.05).Conclusion:Both in earthquake and in normal time,treating the severity polytrauma by damage control orthopedics can acquire satisfied effect.
引文
[1]Ruedi TP,Murphy WM主编.王满宜,杨庆铭,曾炳芳,等译.骨折治疗的AO原则.北京:华夏出版社,2003.661671.
[2]王爱民,孙红振,杜全印,等.骨关节型严重多发伤的损害控制治疗.中华创伤杂志,2007,23(2):143146.
[3]Rotondo MF,Schwab CW,McGonigal MD,et al.Damage control:anapproach for improved survival in exsanguinating penetrating ab-dominal injury.J Trauma,1993,35(3):375382.
[4]王爱民,蒋耀光.以骨关节损伤为主的严重多发性损伤的救治.创伤外科杂志,2006,8(4):382385.
[5]Harwood PJ,Giannoudis PV,van Griensven M,et al.Alterations in the systemic inflammatory response after early total care and dam-age control procedures for femoral shaft fracture in severely injured patients.J Trauma,2005,58(3):446452.
[6]Pape HC,Hildebrand F,Pertschy S,et al.Changes in the manage-ment of femoral shaft fractures in polytrauma patients:from early total care to damage control orthopedic surgery.J Trauma,2002,53(3):452461.
[2]王爱民,孙红振,杜全印,等.骨关节型严重多发伤的损害控制治疗.中华创伤杂志,2007,23(2):143146.
[3]Rotondo MF,Schwab CW,McGonigal MD,et al.Damage control:anapproach for improved survival in exsanguinating penetrating ab-dominal injury.J Trauma,1993,35(3):375382.
[4]王爱民,蒋耀光.以骨关节损伤为主的严重多发性损伤的救治.创伤外科杂志,2006,8(4):382385.
[5]Harwood PJ,Giannoudis PV,van Griensven M,et al.Alterations in the systemic inflammatory response after early total care and dam-age control procedures for femoral shaft fracture in severely injured patients.J Trauma,2005,58(3):446452.
[6]Pape HC,Hildebrand F,Pertschy S,et al.Changes in the manage-ment of femoral shaft fractures in polytrauma patients:from early total care to damage control orthopedic surgery.J Trauma,2002,53(3):452461.
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