创伤控制理论在急诊严重多发伤患者保肢治疗中的应用

Application of trauma control theory in limb salvage treatment

目的探讨创伤控制理论在保肢治疗中的应用。方法选择2012年6月至2014年12月急诊收治的35例肢体损伤患者,以创伤控制理论为依据进行分期治疗,早期急救控制出血、污染、临时固定,转ICU进一步治疗、待病情稳定后,最后二期再行确定性手术,可大大提高患者的生存率和降低致残率。结果 35例患者中,保肢成功32例(91%),各骨折部位达到骨性愈合,创面闭合良好,肢体恢复满意;因骨与软组织缺损伴严重感染、骨髓炎伴窦道长期不愈合、骨鳞癌变等原因而行截肢术3例(9%)。结论采取创伤控制理论进行分期治疗,可以提高患者的生存率和保肢的成功率,减少并发症,促进患者肢体功能恢复。

Objective To assess the application of trauma control theory in limb salvage treatment. Methods Thirty five emergency cases of limb trauma were admitted in Zhejiang Tongde Hospital between June 2012 and December 2014 De- cember and treated with the methods of trauma control. The patients were treated with emergency bleeding control, contamina- tion management and temporary fixation, then were transferred in ICU, until condition was stable the certain surgery was per- formed. Results Among 35 patients, 3 cases were ultimately amputated due to bone soft tissue defect with severe infection, os- teomyelitis with long-term fistula, and bone squamous cancer, respectively; the remained 32 cases were all successful in limb salvage with a limb salvage rate of 91% and a infection rate of 9%. All 32 patients achieved osseous healing, wound closure and satisfactory recovery of limb function, Conclusion The application of trauma control theory can effectively improve limb salvage success rate, reduce complications, promote the recovery of limb function.