基层医院严重多发伤中骨折的损伤控制治疗

目的探讨严重多发伤伴骨折患者在基层医院的损伤控制治疗。方法回顾性分析我院2006年1月—2011年1月应用损伤控制(早期迅速、有效的骨折固定及清创,术后ICU进一步复苏,病情平稳后行确定性手术)救治的25例严重多发伤伴骨折患者的临床资料。结果 25例中抢救成功22例(88.0%),死亡3例(12.0%)。骨盆骨折及四肢不稳定骨折早期予以外固定架固定,其中10例作为确定性固定手段。结论损伤控制同样适用于基层医院严重多发伤伴骨折患者的治疗,但应准确把握其适应证。外固定架在骨折的早期固定中具有重要意义,值得推广。

Application of damage control in severe multiple injury with fractures in primary hospital

Objective To investigate the effect of damage control in treatment of severe multiple injury with fractures in primary hospital.Methods The clinical data of 25 cases of severe multiple injury with fracture were analyzed retrospectively from January 2006 to January 2011.The therapy process include early,granted debridement,temporary fixation of fractures;then,recovery in the ICU;finally,the definitive operation on the fracture with the permission of patient’s condition.Results In a total of 25 patients,22 patients received the successful operation,3 cases died(12.0%).External fixation was applied in most of cases,and as definitive technique for fixation of bone fracture in 10 cases.Conclusion Damage control is also suitable for the treatment of severe multiple injury in primary hospital,but the indication should be accurate grasp.The early external fixation can be widely used for fixation of fracture.