损伤控制外科在严重多发伤救治中的临床应用

目的探讨和总结损伤控制外科(damage control surgery,DCS)技术在抢救严重多发伤中的治疗和处理。方法回顾性分析129例严重多发伤(ISS评分平均34.2分)患者采取DCS技术治疗的临床效果。结果 129例严重多发伤患者中,采用DCS技术后存活102例,死亡27例,死亡率20.93%(27/129)。死亡27例中,早期死于急性大出血11例,严重颅脑损伤5例,严重胸部损伤3例,颈椎骨折并高位截瘫2例,晚期2例死于ARDS,4例死于MOF。结论将DSC技术合理使用在严重多发伤的抢救中,能增加患者的"生理潜能",纠正严重的内环境紊乱,使安全度过创伤的急性反应期,能够明显提高患者的生存率,有相当的临床使用价值。

Damage Control Surgery in the Treatment of Severe Multiple Injuries

Objective To discuss and summarize the damage control surgery（DCS） in the treatment of severe multiple injuries. Methods Retrospective analysis of 129 patients with severe multiple trauma （ with a mean ISS score of 34.2 points） treated by DCS was conducted. Results There were 102 patients survived and 27 patients died; with the mortality rate of 20.93% （27/129）. There were 5 patients died of severe head injury, 3 patients of severe chest injury, 11 patients of acute bleeding, 2 patients of cervical spine fractures and paraplegia, 2 patients of ARDS and 4 patients of MOF. Conclusions The rational use of the DCS in the rescue of severe multiple injuries can increase the patient＇s ＂physiological potential＂ to correct a serious disturbance in the internal environment, so that can lead the patients to placidly live through the trauma of the acute reaction, and can significantly improve the survival rate.