损伤控制外科在老年严重外伤性肝破裂中的应用研究

Application study of damage control surgery in elderly severe traumatic rupture of liver

目的:探讨在老年严重外伤性肝破裂患者中应用损伤控制外科的效果。方法:2012年1月—2015年1月于我院收治的50例老年严重外伤性肝破裂患者,按照不同的治疗方法,分为观察组24例与对照组26例,观察组患者进行损伤控制外科手术治疗,对照组行确定性手术治疗,对两组患者的治疗效果及相关指标进行比较。结果:观察组患者治疗成功率显著高于对照组,而死亡率、术后并发症发生率均显著低于对照组,比较差异均存在统计学意义(P<0.05);观察组患者的手术时间、术中出血量、凝血酶原时间(PT)与活化部分凝血活酶时间(APTT)等恢复时间及体温恢复时间,均显著低于对照组,差异均存在统计学意义(P<0.05)。结论:在老年严重外伤性肝破裂患者中应用损伤控制外科手术治疗,可显著提高治疗成功率,具有术后恢复快、并发症少、操作快捷等优点,具有较高的临床应用价值。

Objective： To discuss the application effect of damage control surgery in elderly patients with elderly severe traumatic rupture of liver. Methods： 50 cases of elderly patients with severe traumatic rupture of liver hospitalized from January 2012 to January 2015. According to the different treatment methods,a retrospective analysis was given. They were divided into 24 cases of observation group and 26 cases of control group,patients of observation group were given damage control surgery operation treatment,while the patients of control group were given the deterministic operation treatment,the treatment effect and related indexes of patients of both groups were compared.Results： The treatment success rate of patients of the observation group was significantly higher than that of the control group,while the death rate,incidence of postoperative complications were significantly lower than those of control group and the differences had statistical significance（ P〈0. 05）; The operation time,surgery bleeding,prothrombin time（ PT） and activated partial thromboplastin time（ APTT） and recovery time of body temperature of patients of observation group were obviously lower than those of control group,there were statistically significant differences（ P〈0. 05）. Conclusion： Applying damage control surgery treatment in elderly patients with elderly severe traumatic rupture of liver can significantly improve treatment success rate,which have the vantages of fast postoperative recovery,fewer complications,fast operation,and high value in clinical application.