损伤控制性手术对重型颅脑损伤的作用

Effect of damage control surgery in treating severe traumatic brain injury

目的探讨损伤控制性手术在治疗重型颅脑损伤中的价值。方法对2011-03—2013-03我院收治的120例重型颅脑损伤伴多脏器损伤患者采取损伤控制性手术理念进行外科救治(实验组),并与2009-03—2011-03我院收治的120例采取常规手术方法救治的重型颅脑损伤伴多脏器损伤患者(对照组)进行预后及病死率等比较。结果实验组抢救成功78例,成功率65.0%;死亡42例,病死率35.0%。对照组抢救成功51例,成功率42.5%;死亡69例,病死率57.5%。2组成活率及病死率比较差异有统计学意义(P<0.05)。6个月后进行GOS评分,实验组存活患者恢复良好率30.8%(24/78),对照组为9.8%(5/51),2组存活患者术后恢复良好率比较差异有统计学意义(P<0.05)。结论应用损伤控制外科理念处理以重型颅脑损伤为主的患者较常规手术治疗方法有更显著的效果,对减轻或终止患者致命性的脑损害有重要意义。

Objective To investigate the application of damage control surgery in treating severe traumatic brain injury. Methods Totally 120 cases of severe traumatic brain injury patients with multiple injuries admitted to our hospital from March 2011 to March 2013 were selected and divided them into control group and experimental group, the effect of two groups after treatment was compared. Results The treatment success rate and mortality rate were respective 65.0% and 35.0% in experimental group, which were respective 42.5% and 57.5% in control group, there were significant differences between the two groups （P〈0.05）. According to the GOS score followed up 6 months, the good recovery rate of experimental group was higher than that of control group（P〈0.05）. Conclusion Damage control surgery has a significant effect on treating severe traumatic brain injury.