骨科损伤控制技术对不稳定骨盆骨折合并四肢多发骨折患者凝血功能及疗效影响

摘要

Objective To study effect coagulation function and therapy effect of damage control orthopaedics technol-ogy for unstable pelvic fractures with limbs multiple fractures. Method Select the Second Affiliated Hospital of Inner Mongolia Medical University for treatment of unstable pelvic fracture limb multiple fractures in 70 patients for the study, control group given open reduction and internal fixation, observation group given damage control orthopaedics technology staging treatment . Operation indexes, coagulation function, therapy and complications were compared between two groups. Result Observation group operation time, intraoperative blood loss, temperature recovery time, lactic acid removal time, callus were significantly lower than the control group used time(P<0. 05); observation group PT, APTT, TT were significantly higher than the control group, FIB were significantly lower than the control group(P<0. 05);observation group fine rate 85. 71% was significantly higher than the control group 60. 00%(χ2=5. 861, P<0. 05);observation group complications 5. 71% was significantly lower than the control group 31. 43%(χ2=7. 652,P<0. 05). Conclusion Damage control orthopaedics technology helps to correcting the lactic acid level, improve coagulation function, and reduce the postoperative complications, then improve therapy effect.%目的：探讨骨科损伤控制技术对不稳定骨盆骨折合并四肢多发骨折患者凝血功能及治疗效果的影响。方法选取在本院就诊的不稳定骨盆骨折合并四肢多发骨折患者70例,采用随机数字表法分为对照组和观察组各35例,对照组给予一期切开复位内固定术,观察组给予骨科损伤控制下分期治疗术。比较两组手术相关指标、凝血功能、治疗效果、并发症。结果观察组手术时间、术中出血量、体温恢复时间、乳酸清除时间、骨痂所用时间均明显低于对照组(P均<0.05)；凝血功能：观察组凝血酶原时间(prothrombin time,PT)、血浆活化部位凝血酶时间( activated partial thromboplastin time,APTT)、凝血酶时间( thrombin time, TT)明显高于对照组,纤维蛋白原(fibrinogen,Fib)明显低于对照组(P均<0.05)；观察组优良率85.71%明显高于对照组60.00%(χ2=5.861,P<0.05)；观察组并发症5.71%明显低于对照组31.43%(χ2=7.652,P<0.05)。结论骨科损伤控制技术有助于快速纠正患者乳酸水平,改善凝血功能,降低术后并发症,提高治疗效果。