损伤控制外科在重度腹部交通伤中的应用

Application of Damage Control Surgery in Severe Abdominal Traffic Injury

目的探讨损伤控制外科在重度腹部交通伤中的临床应用价值。方法回顾性分析46例应用损伤控制外科治疗的重度腹部交通伤患者的临床资料,首先对其进行院前与院内初步救治,然后按损伤控制外科原则进行初始简化手术、ICU复苏及再次确定性手术。结果 46例重度腹部交通伤患者均采用损伤控制外科技术治疗,42例经ICU复苏后顺利完成再次确定性手术,41例痊愈出院,1例术后死于MODS;4例在ICU复苏期内死亡,死亡原因为MODS、继发严重感染。结论院前与院内初步急救为重度腹部交通伤救治创造了条件;对符合DCS指征的患者合理运用损伤控制外科技术,可提高重度腹部交通伤救治成功率。

Objective To explore the clinical application value of damage control surgery（DCS） in severe abdominal traffic injury.Methods 46 cases of severe abdominal traffic injury were selected as the object of DCS,first with its initial pre-hospital and hospital treatment,then with the principle of damage control surgery initially simplify the operation,ICU resuscitation and definitive surgery again,the clinical data was reviewed retrospectively.Results 46 cases of severe abdominal traffic injury patients were treated with damage control surgical treatment,42 patients with ICU recovery again after the successful completion of definitive surgery,41 patients were discharged,1 patient died of MODS;4 cases were dead of the recovery period in the ICU,the cause of death was MODS,which was secondary to severe infection.Conclusion Pre-hospital and hospital first aid created the conditions for treatment of severe abdominal traffic injury;the reasonable use of DCS in patients with indications for damage control surgical techniques can improve successful treatment rate with severe abdominal traffic injury.