损害控制性手术理念在严重创伤救治中的应用

目的探讨运用损害控制性手术(damage control operation,DCO)救治严重创伤患者,并选择适宜手术时机的临床应用。方法对于2008年8月～2011年1月收治的以DCO原则处理21例严重创伤、复合伤的临床资料进行分析。结果患者损伤包括四肢骨折、四肢严重软组织撕脱伤。平均损伤严重度评分(ISS)30.3±2.1,格拉斯哥昏迷评分(GCS)9.3±2.2。死亡1例,上臂截肢1例,2例感染治疗后痊愈;随访20例,结果满意。结论对严重创伤患者进行损害控制性治疗,选择适宜的手术时机,降低手术风险,疗效满意。

Damage control operation for treating severe trauma

Objective To investigate the efficacy of damage control operation in treating severe trauma,and to analyze the appropriate operative time.Methods Analysis was performed on 21 cases of multiple trauma from Aug.2008 to Jan.2011,who were treated with damage control operation strategy in our department.Results There were extremity fractures,severe soft tissue avulsed injury of limbs.The average ISS score was 30.3,GCS was 9.3.One patient died,one patient received upper limbs amputation,and two patients with infection healed after treatment.Totally 20 cases were followed up with satisfactory results.Conclusion For treating severe multiple trauma patients,using damage control operation and choosing appropriate operative time could reduce the operation risk and achieve satisfactory curative effect.