损伤控制外科技术在小儿严重胸部创伤急救中的应用

目的 探讨损伤控制外科技术(damage control surgery,DCS)在小儿严重胸部创伤急救中的应用疗效.方法 回顾性分析我科应用损伤控制外科技术救治的10例严重胸部创伤的小儿患者与常规外科手术治疗的5例胸部外伤小儿患者临床资料,分为DCS组和对照组.比较两组患者术前创伤严重程度评分(ISS)及复苏期患者体温、血pH值、PT值和血氧饱和度值变化情况.结果 术前DCS组和对照组ISS评分分别为24.28±6.43和23.54±5.96,两组差异无统计学意义(P＞0.05)；复苏期体温变化两组分别为(37.04±0.62)℃和(36.46±0.94)℃,差异无统计学意义(P＞0.05),DCS组体温变化更趋于平稳；DCS组和对照组复苏期血pH值分别为7.38±0.10和7.26±0.07、PT值分别为21.34±5.20和29.82±6.25和血氧饱和度值分别为(96.43±4.38)％和(90.18±3.25)％,两组相比差异有统计学意义(P＜0.05)；两组患儿术后康复情况比较,DCS组明显优于对照组.结论 对于严重胸部创伤的小儿患者采用损伤控制外科手术处理效果明显优于传统常规手术,在挽救生命的同时对促进术后患儿康复亦起着重要作用.

Application of damage control surgery for children in emergency of severe chest trauma

Objective To explore the effect of damage control surgery on children in emergency of severe chest trauma.Methods The population included 10 severe chest trauma patients undertaking damage control surgery (DCS) and 5 patients with same condition undertaking conventional surgical treatment.They were divided into DCS and control groups.The retrospective summarization and analysis were conducted for their clinical data,involving pre - operative injury severity score ( ISS),body temperature,arterial blood pH,and prothrombin time (PT),as well oxygen saturation,aiming to compare and evaluate the therapeutic efficacy of both groups.Results No statistical significance could be seen for ISS (24.28 ± 6.43 vs 23.54 ± 5.96) and body temperature (37.04 ± 0.62 vs 36.46 ± 0.94) in both groups (P＞0.05).Nonetheless,the body temperature was found to be more likely to tend to stable in DCS group.Furthermore,no significant difference could be noted in both groups for the arterial blood pH (7.38 ± 0.10 vs 7.26 ± 0.07),PT (21.34 ± 5.20 vs 29.82 ± 6.25) and oxygen saturation (96.43 ±4.38 vs 90.18 ±3.25) (P＜0.05).In term of rehabilitation,the DCS group was superior to the control group.Conclusions Regarding to the children with severe chest trauma,DCS is a more reliable technique in contrast to conventional surgical procedure,and plays an important role in remedy rate and rehabilitation for children in emergency of severe chest trauma.