伴1/3躯体毁损的严重多发伤的救治

Successful treatment of 1/3-body smashed with severe multiple trauma

目的总结严重躯体毁损伤抢救的经验。方法报告1例因车祸致1/3躯体毁损患者,ISS90评分为43分。经过电话指挥当地医院初级救治、入院后快速有效抗休克、手术止血、半骨盆切除、损害控制、ICU监护、再造人工肛门、多次清创植皮等救治措施。结果患者于伤后102天创面痊愈出院,可扶双拐行走。结论创伤救治网络中各环节有机连接,发挥多学科合作,运用损伤控制理论,综合运用各项救治措施处理创面等是本例成功救治的关键。

Objective To summarize the experiences in treating traumata that caused severe bodily impairment. Methods A 31-year-old patient with 1/3 of the body smashed,43 of ISS90 score,has been successful salvaged through a series of proper managements guided by current damage control principles including anti-shock, traumatic hemipelvectomy,resuscitation in ICU and more definitive operation later stages. Results The patient was cured and could walk on the crutches after 102-day＇s treatment. Conclusion The effective experience are as follows： effective local traumatie therapy network, consultations and cooperation of interdisciplinary specialists, the use of current damage control principles ,and the use of various wound closure techniques.