严重腹外伤采用损伤控制手术治疗临床体会

摘要

目的：探讨采用损伤控制手术治疗严重腹外伤的临床效果。方法：选取笔者所在医院2013年1月-2014年1月收治60例严重腹外伤患者作为研究对象，按照随机数字表法将其分为观察组和对照组各30例，观察组采用损伤控制手术治疗，对照组采用常规手术治疗，观察比较两组患者的手术持续时间、休克纠正时间、多脏器功能不全及临床并发症发生情况。结果：观察组的手术持续时间、休克纠正时间均明显短于对照组，且多脏器功能不全率20.0%和临床并发症发生率3.3%均明显低于对照组的50.0%和26.7%，差异均有统计学意义(P<0.05)。结论：损伤控制手术不同于急诊手术和常规手术，属阶段性修复策略，为应急分期手术理念，以确保治愈率和生存率为目标，对病情危重、全身状况差的患者较适用，可缩短病程，降低不良事件发生率，对保障预后有非常重要的意义。%Objective:To investigate the clinical effect of damage control surgery in the treatment of severe abdominal trauma.Method:60 patients with serious abdominal trauma in our hospital from January 2013 to January 2014 were selected as research objects,they were divided into the observation group and the control group according to the random number table method,30 cases in each group.The observation group was treated with damage control surgery,and the control group was treated with conventional surgery.The duration of surgery,time of correcting shock,multiple organ dysfunction and incidence of clinical complications between the two groups were observed and compared.Result:The duration of surgery and the time of correcting shock in observation group were significantly shorter than those in control group,and the multiple organ dysfunction rate and incidence of clinical complications were 20.0%and 3.3%,which were significantly lower than 50.0%and 26.7%in control group,the differences were statistically significant(P<0.05).Conclusion:Damage control surgery is different from emergency surgery and conventional surgery,is a phased restoration strategies for emergency surgical staging concept,in order to ensure the cure rate and survival as the goal of critically ill patients with poor general condition,more suitable for applications,shorten the course,reduce the incidence of adverse events,and is very important to guarantee the prognosis.