损伤控制性手术与常规Ⅰ期手术用于肝胆外科创伤患者中的临床对比

Comparison of damage control operation and conventional one-stage operation in treating patients with hepatobiliary trauma

目的 对比分析损伤控制性手术与常规Ⅰ期手术应用于肝胆外科创伤患者治疗中的临床效果.方法 2011年9月至2013年9月收治的肝胆外科创伤患者中随机选择89例进行研究,随机分为观察组（45例）和对照组（44例）,分别给予损伤控制性手术与常规Ⅰ期手术治疗.观察两组的治疗效果和并发症情况,并进行比较.术后随访1～6个月,采用电话随访的方式,了解患者的术后情况.随访率为100％.使用SPSS 15.0软件进行统计分析,计量资料予以t检验,计数资料予以x2检验.P ＜0.05则视为差异有统计学意义.结果 观察组的手术时间和住院天数分别为（64.2±12.7） min和（27.3±6.4）d,显著短于对照组的（98.4±24.6） min和（42.6±11.2）d,（t=8.64,6.83,均P＜0.05）.观察组的并发症发生率为13.3％ （6/45）,显著低于对照组的27.3％（12/44）,差异有统计学意义（x2 =9.11,P＜0.05）.结论 较之常规Ⅰ期手术治疗,利用损伤控制性手术治疗肝胆外科创伤患者可以获得较好的临床效果,且有效降低并发症发生率,疗效确切,值得推广.

Objective To investigate the clinical effect of damage control operation and conventional one-stage operation in treating patients with hepatobiliary trauma.Methods From September 2011 to September 2013,89 patients with hepatobiliary trauma were randomly divided into observation group （45 patients） and control group （44）,who received damage control operation and conventional one-stage operation treatment respectively.The therapeutic effect and complications in the two groups were observed and compared.All the patients were followed up for 1-6 months by phone call,and postoperative status of the the patients was monitored.SPSS 15.0 software was used for statistical analysis.Measurement data were subjected to Student＇s t test,and count data to the chi-square test.P ＜ 0.05 was considered statistically significant.Results The operation time and hospital stay in the observation group were （64.2 ± 12.7）minutes and （27.3 ± 6.4） days,which were significantly shorter than （98.4 ± 24.6） minutes and （42.6 ± 11.2） days in the control group respectively （t =8.64,6.83,P ＜ 0.05）.The complication rate the in observation group was 13.3％（6/45）,which was significantly lower than 27.3％ （12/44） in the control group （x2 =9.11,P ＜ 0.05）.Conclusion Damage control treatment is better than conventional one-stage surgery in the treatment of patients with hepatobiliary trauma,and the incidence of complications could be effectively reduced.