损伤控制手术在多发骨折为主的多发伤患者中的应用

APPLICATION OF DAMAGE CONTROL SURGERY FOR THE MULTIPLE TRAUMA PATIENTS WITH POLYFRACTURES

目的分析损伤控制手术在多发骨折为主的多发伤患者中应用的可行性、适应症和效果。方法将我院2008年1月～2013年10月多发骨折为主的多发伤患者96例进行回顾性分析，损伤严重程度评分（ISS）均／〉25分，将应用损伤控制手术（DCO）原则方法治疗多发骨折的48例作为观察组，将未应用损伤控制手术（DCO）原则方法治疗多发骨折的48例作为对照组，比较两组的死亡率、并发症。结果两组比较．观察组的死亡l例，并发症3例；对照组的死亡5例，并发症11例，两组死亡率、并发症率比较均有统计学意义（P〈0．01）。结论损伤严重程度评分（ISS）≥25分多发骨折的患者应用损伤控制手术（DCO）原则方法治疗符合多发骨折的病情特点，早期针对性的处理结合后期一体化的治疗，有助于提高患者的生存率及生存质量。

Objective To analyse the damage control surgery in treatment of multiple fractures trauma, thus to evaluate its feasibility, indications and effects. Methods we evaluated 96 cases of multiple fractures of multiple trauma patients from January 2008 to October 2013, each of whose injury severity score （ISS） are higher than 25 points, we made 48 damage control operation（DCO） principle treated cases as observe group, while the other 48DC0 -untreated cases were compared as control group, we compared the mortality and the complications of these two groups. Results Compared the two groups, the observe group showed 1 death cases and 3 complication cases, while there were 5 death cases and 11 complication cases in the control group, the mortality and complication rate between two groups were statistically significant （p 〈 0. 01 ）. Conclusion The multiple fractures patients, that Injury severity score （ISS） more than 25 points with principle of damage control operation （DCO） method in treating was accorded with multiple fractures Patients condition, meanwhile, the early specific treatment combined with the late integrated treatment is conducive to improve survival and quality of life.