伤害控制骨科原则治疗骨盆型严重多发伤

Treatment of severe multiple injuries in pelvic trauma with damage control orthopaedics strategy

目的:探讨伤害控制骨科原则在救治骨盆型严重多发伤中的作用并总结其经验。方法:系统回顾2005年9月至2009年3月运用伤害控制骨科原则治疗的以骨盆骨折为主的严重多发伤患者31例,男22例,女9例;年龄17～63岁,平均30.5岁;ISS平均32.7分。结果:所有病例均成功复苏,无死亡病例,术后外固定架针道浅表感染2例,深部伤口感染2例,下肢深静脉血栓1例,肺部感染1例,褥疮1例。31例患者均获得随访,时间3～29个月,平均10个月。按Matta等评价标准:优12例,良11例,可7例,差2例。结论:合理应用伤害控制骨科原则治疗骨科严重多发创伤患者,可降低早期手术规模及手术治疗风险,提高临床效果,是一种安全有效的治疗方式。

Objective：To study and summarize the clinical application and results of the damage control orthopedics（DCO） strategy in treating severe multiple injuries in pelvic trauma. Methods：From September 2005 to March 2009,31 patients with severe multiple injuries,mainly with pelvic trauma,were treated with DCO strategy. There were 22 males and 9 females,ranging in age from 17 to 63 years with an average of 30.5 years. The mean of injury seveirty score（ISS） was 32.7 scores. Results：All the patients obtained a successful resuscitation and there was no deaths. The complications were in 7 cases included 2 with superficial nail trace infection,2 with deep wound infection,1 with deep venous thrombosis of lower extremity,1 with pulmonary infection,1 with decubital ulcer. The mean of follow up period was 10 months （ranged,3 to 29 months）. According to Matta standard,12 cases got excellecnt result,11 good,7 fair,2 poor. Conclusion：The DCO strategy is a safe and effective method in treating severe multiple injuries in pelvic trauma,if it can be reasonably performed,it can reduce early operative extents and risks,improve the clinical effects.