不稳定型骨盆骨折合并多发伤的损伤控制

目的探讨损伤控制骨科(damage control orthopaedics,DCO)技术在不稳定型骨盆骨折合并多发伤中的应用。方法回顾性分析应用DCO技术治疗的43例不稳定型骨盆骨折合并多发伤患者的临床资料:第一阶段用骨盆外固定支架固定不稳定型骨盆骨折,并进行其他简化手术、控制致命性大出血;第二阶段行ICU复苏治疗;第三阶段行确定性修复重建手术。结果 2例死亡,4例未随访,37例平均随访23.6月。按Matta标准评定疗效:优18例,良12例,可2例,差5例,总优良率81.1%。结论不稳定型骨盆骨折合并多发伤病情较重,采用DOC技术有利于稳定血流动力学,提高救治成功率,降低死亡率和伤残率。

Damage Control Orthopaedics for Unstable Pelvic Fracture Complicated with Polytrauma

Objective To evaluate the effect of damage control orthopaedics（DCO） for unstable pelvic fracture complicated with polytrauma.Method 43 cases of unstable pelvic fracture complicated with polytrauma treated with DCO were retrospectively analyzed.Results Of the 43 cases,2 died,4 missed follow-up and 37 were followed up for 23.6 months averagely.According to Matta evaluation system,the outcome revealed excellence in 18,good in 12,fair in 2 and false in 5,and the fineness rate was 81.1%.Conclusions The unstable pelvic fracture with polytrauma are often associated with other important organ injuries.The application of DCO may keep the stabilization of the hemodynamics,improve the success rate and reduce mortality and disability rate.