高原地区严重创伤患者的救治体会(附154例报道)

目的 探讨高原地区严重创伤救治一体化及应用损伤控制理论对提高严重创伤救治水平的影响.方法 回顾分析2007-01～2009-09收治的环青海湖地区154例严重多发伤患者的资料.按救治方法 (一体化救治和非一体化救治)和手术原则(损伤控制手术和确定性手术)分为三组.结果 急救一体化救治、非一体化救治和确定性手术组比较,急救一体化救治和损伤控制(或确定性手术)组的病死率降低(P＜0.05),确定性治疗前时间、手术持续时间、LTD恢复时间、入住ICU时间及总住院时间均明显缩短,术中输血量明显减少(P＜0.05).结论 在严重多发伤救治中,高原地区采用急救一体化救治模式并早期应用损伤控制理论能显著减少并发症,降低病死率,缩短住院时间,改善患者的预后.

Treatment experience of the patients with severe trauma in high altitude area ( a report of 154 cases)

Objective To investigate the effects of integrated treatment and damage control on the improvement of treatment level of severe trauma in high altitude area. Methods To retrospectively analyze 154 cases' information with severe multiple trauma treated from Jan. 2007 to Sep. 2009. According to treatment methods (integrated treatment and non-integrated treatment) and surgical principles (damage control operation and definitive operation),154 cases were divided into three groups. Results Compared with non-integrated treatment group, the mortality reduced significantly in integrated treatment and damage control (or definitive operation) group (P<0.05). Compared with non-integrated treatment group+definitive operation group, certainty of pre-treatment time, operation duration, LTD recovery time, ICU and total hospitalization time were significantly shorter, intraoperative blood transfusion was significantly less in integrated treatment group+damage control group(P<0.05). Conclusion The treatment of integrated treatment and early damage control theory can significantly reduce complications and lower mortality, shorten hospitalization and improve the prognosis of patients with severe multiple injuries in high altitude area.