损伤控制外科理念在严重腹部创伤中的应用价值

Application of damage control surgery for severe abdominal trauma

目的探讨损伤控制外科（DCS）理念在严重腹部创伤中的应用价值。方法回顾性分析46例按DCS原则进行救治和58例未按DCS原则进行救治的严重腹部创伤患者的临床资料。DCS救治分为简单快速手术、复苏治疗和再次确定性手术3个步骤实施。比较两组患者围手术期死亡率和并发症发生率。结果DCS组和非DCS组患者围手术期死亡率分别为15．2％（7／46）和34．5％（20／58），差异有统计学意义（Х^2=4．954，P=0．026）；围手术期总并发症（包括围手术期死亡病例）发生率分别为37．0％（17／46）和67．2％（39／58），差异有统计学意义（Х^2=9．468，P=0．002）。结论按照DCS理念对严重腹部创伤患者进行救治，可明显降低围手术期死亡率和并发症发生率，疗效满意，值得推广。

Objective To evaluate the value of damage control surgery （DCS） for severe abdominal trauma. Methods Forty-six patients with severe abdominal trauma were treated according to DCS principles and 58 patients were not. Clinical data of the two groups were analyzed retrospectively. DCS included simple surgery, resuscitation, and definitive operation. Results Perioperative morality was 15.2%（7/46） in the DCS group and 34.5%（20/58） in the non-DCS group, and the difference was statistically significant （Х^2=4.954, P=0.026）. The perioperative complication rate was 37.0% （ 17/46 ） in the DCS group and 67.2% （39/58） in the non-DCS group, and the difference was statistically significant（Х^2=9.468,P=0.002）. Conclusion Damage control surgery can reduce perioperative morbidity and mortality in patients with severe abdominal trauma, and its efficacy is satisfactory.