伤害控制骨科学在脊柱损伤多发伤中的应用

"伤害控制骨科学"的理念源于伤害控制外科发展而来并且成功应用到四肢骨折的治疗上。伤害控制骨科学是一种稳定骨科损伤以使患者全身生理状态提高的方法。它的目的是避免由于"二次打击"造成患者病情恶化并且延迟确定性骨折修复直到患者全身情况达最佳状态。近来这个理念扩展到脊柱损伤合并严重损伤的患者中。本文综述了脊柱损伤多发伤手术时机、"伤害控制骨科学"应用的适应证、二次手术时机和微创技术的研究进展。

Damage Control Orthopedics Apply to Spine Injury with Polytrauma

The concept of ＂damage control orthopedics＂ was originally developed from damage control surgery and also successfully applied to the management of long bone fractures. Damage control orthopedics is an approach that stabilizes orthopedic injuries so that the patient＇s overall physiology can improve. Its purpose is to avoid worsening of the patient＇s condition by the＂ second hit＂ and to delay de- finitive fracture repair until a time when the overall condition of the patient is optimized. More recendy this has been extended to severely injured patients with spine injuries. This review summarized the de- velopment of surgical operation time of spine injury with polytrauma patients, indication of ＂ damage control orthopedics＂ ,timing of second surgery and minimally invasive technique.