损伤控制在严重骨盆骨折合并其他脏器伤治疗中的应用

目的 探讨损伤控制理念应用在严重骨盆骨折合并伤救治过程中的临床价值. 方法 回顾性收集57例骨盆严重损伤合并不同部位多发损伤患者的临床资料,57例患者ISS评分32.7±3.18分（25～39分）.通过骨盆急救相对简单固定同时多学科协作对相关危及生命的损伤积极处理等损伤控制操作及损伤控制手术进行早期干预.分析各种损伤控制方法在不同骨盆合并伤中的应用效果. 结果 57例骨盆复杂骨折合并其他颅脑损伤、泌尿系统损伤、腹部损伤、四肢脊柱骨折、胸部损伤患者中,经伤害控制后,ISS评分明显下降至21.27±2.2分（7 ～ 29分）（P＜0.05）,55例患者成功手术治疗康复出院,2例死亡. 结论 根据骨盆骨折及合并伤特点实施损害控制,进行早期的生命损害救治,控制损伤发展,为骨盆骨折的手术治疗及最后转归创造机会.

Damage Control in Severe Pelvic Fractures Associated withOther Applications in the Treatment of Organ Injury

Objective To investigate the clinical value of the damage control concept used in treatment of severe pelvic fracture injuries. Methods Recalling Shenzhen Baoan People＇s Hospital from September 2005 to March 2005 were 57 cases of pelvic diagnosis and treatment of severe damage with different parts of multiple damage after,57 cases of patients, ISS score highest 39 points ; Minimum 25 points ; An average of 32.7 points ; Through the pelvis first aid relatively simple fixed multidisciplinary collaboration at the same time actively processing to the life-threatening injury and damage control operation and damage control surgery for early intervention. Analysis of all kinds of damage control method applica- tion effect in different pelvic united injury. Results 57 complex pelvic fracture combined traumatic brain injury,other u- rinary system injury, abdominal injury, extremities, spine fracture,in patients with chest injury, after damage control,55 ca- ses of successful surgical treatment rehabilitation hospital discharge,2 cases died. Conclusion according to the charac- teristics of pelvic fractures and combined injury to implement damage control, the life of early damage treatment, control the damage,for the surgical treatment of pelvic fractures and the final outcome to create opportunities.