损伤控制骨科理论指导一体化救治模式在骨科严重多发伤中的应用

Application of damage control orthopaedics guiding the integrated emergency mode of prehospital and inhospital in the severe multiple trauma patients with orthopaedic trauma

目的探讨损伤控制骨科（damage control orthopaedics，DCO）理论在骨科严重多发伤中的可行性和有效性。方法回顾性分析采用DCO理论指导一体化救治模式后骨科严重多发伤的救治疗效。自2009—01—2011—12在院前、院内一体化救治模式下，骨科严重多发伤采用DCO理论进行救治，比较连续三年的疗效变化，包括来院至接受确定性手术的时间、ICU住院时间、总住院时间、并发症和死亡率等。结果DCO理论指导一体化救治模式具有可行性，临床效果明显，缩短了ICU的住院时间，显著缩短了严重多发伤患者人院至接受确定手术的时间，明显降低了多发伤患者的并发症和死亡率。结论运用DCO理论指导骨科多发创伤的一体化治疗，可以降低患者的死亡率，提高救治成功率。

Objective To explore the feasibility and efficacy of damage control orthopaedics （DCO） in treating severe polytrauma patients combined with orthopedic trauma. Methods A retrospective analysis was performed in 82 eligible polytrauma patients with injury severity score 〉 25. From January 2009 to December 2011, the DCO was used to guide the integrated emergency mode of prehospital and inhospital in the severe polytrauma patients with orthopaedic trauma. The time from the admission to definitive surgery, ICU length of stay, total hospital stay, complications and mortality were compared. Results The DCO guiding the integrated emergency mode of prehospital and inhospital could shorten ICU length of stay and the time from the admission to definitive surgery, and lower complications and mortality. Conclusion It is a feasible and effective method in treating severe polytrauma patients combined with orthopaedic trauma by the DCO guiding the integrated emergency mode of prehospital and inhospital.