腹部损伤控制性手术的理念、内涵及护理应对

Concept,Connotation and Nursing of Damage Control Surgery

外科危重疾病如腹部严重战创伤、腹腔大出血、严重腹腔感染、腹腔间室综合征,患者往往合并代谢性酸中毒、低体温、凝血功能障碍、多脏器功能不全,必须紧急外科手术处理,但此类患者又难以承受较长的手术时间。此时,外科手术理念必须从传统模式中摆脱出来,这不仅是手术的成功率,更重要的是患者的存活率。因此,损伤控制性手术(DCS)应运而生,并且近年来有了很大的发展,从仅适用于外伤濒死患者的外科技术,拓展为危重患者外科治疗的一种新理念,对其相应的护理工作亦有着巨大挑战。作者就这一理念和内涵阐述其发展历程、理论依据、适应证及治疗策略,制订出护理工作的积极应对措施,明确每一治疗阶段的护理重点,为成功救治危重患者发挥积极作用。

Critical problems such as severe trauma, abdominal hemorrhea, intra-abdominal infection and abdominal compartment syndrome are frequently complicated by acidosis, hypothermia, coagulopathy and MODS and require emergent surgical treatment, but meanwhile the patients cannot bear long and complex surgery. Thus damage control surgery （DCS） came into being and has gained increasing development. Nowadays, the conditions indicative of DCS have expanded from moribund traumatic to critical problems. Nursing work during the DCS period is important and challenging as well.