损伤控制性手术救治严重腹部损伤

目的：通过对严重腹部损伤患者实施损伤控制性手术策略和方法，提高创伤的抢救成功率。方法：回顾分析8例严重腹部损伤（ISS〉16）患者应用损伤控制性手术的策略进行救治的情况，8例患者入院后在积极抗休克急救处理的同时进行急诊剖腹探查手术，初期均采用大纱垫填塞的方法控制出血后关腹，ICU内复苏后，所有患者都进行了Ⅱ期计划性手术。结果：经过损伤控制性手术救治的严重损伤复苏过程较平稳，腹部并发症得到有效控制。痊愈6例，死亡2例。术后出现膈下感染1例，胆瘘1例，经引流治疗痊愈。结论：对于符合DCO指征的严重腹部损伤的患者要尽早、尽快地实施DCO，提高综合治疗水平，根据腹部损伤的部位和程度，采取适宜的再次确定手术的方式，可以有效地降低严重腹部损伤病死率。

Application of Damage Control Operation on Serious Abdominal Trauma

Objective： To search new treatment approach in order to increase the cure rate by the application of damage control strategy and methods on the patient with serious abdominal trauma. Methods： The remedy condition of the damage control strategy of 8 patients with serious abdominal trauma（ISS〉16） were analyzed retrospectively. 8 patients being carried on emergency exploratory laparotomy while resisting the first aid of shock to deal with actively,adopting the method of big bandage plugging to stop bleeding then shutting abdomen,after anabiosis in ICU,all of the patients being carried on Ⅱ A planned operation. Results： The patients on damage control operation with serious abdominal trauma recovered equability, the abdomen complication was controled utility. 6 patients were cured,2 died. 1 patient appearanced postoperative subdiaphragmatic infection, l bile leakage,was cured by drainage treatment. Conclusion： The patients with serious abdominal trauma must be carried on DCO as soon as possible who consistent with DCO sign, it can increase the level of combined modality therapy. According to the abdominal trauma＇s position and intensity, adopt suitable modus operandi, it can decrease the fatality rate of the patient with serious abdominal trauma effectually.