基于外科损伤控制理论的三阶段分期处理原则用于外伤性肝损伤的临床效果观察

Clinical effect of the three stage processing principle based on the theory of damage control surgery in treatment of traumatic liver injury

目的探讨基于外科损伤控制理论（DCS）的三阶段分期处理原则在治疗外伤性肝损伤上的临床效果。方法将我院于2015年1月～2016年2月收治的48例外伤性肝损伤患者作为DCS组，该组患者均采用三阶段分期损伤控制性手术进行治疗；并选择2013年1月-2014年2月我院收治的43例外伤性肝损伤患者作为非DCS组，该组患者均行早期确定性手术，未应用DCS技术进行治疗。就两组患者的平均手术时间、住院时间、病死率及并发症发生率进行分析比较。结果DCS组患者的病死率为10．42％，低于非DCS组（27．91％），而DCS组患者的手术时间低于非DCS组，住院时间则高于非DCS组，组间差异比较有统计学意义（P〈0．05）。DES组的并发症发生率为14．58％，而非DCS组的并发症发生率为37．21％，两组患者之间差异有统计学意义（P〈0．05）。结论采用基于外科损伤控制理论的三阶段分期处理原则对外伤性肝损伤进行治疗，能够有效降低病死率和并发症发生率，患者的预后得到显著改善，值得在临床治疗上积极推广。

Objective To research the clinical effect of the three stage processing principle in treatment of traumatic liver injury based on the theory of damage control surgery（DCS）. Methods 48 cases of patients with traumatic liver injury cured in our hospital from January 2015 to February 2016 were selected as the DCS group, and the patients were treated with three stage damage control surgery. And 43 patients with traumatic liver injury in our hospital from January 2013 to February 2014 were selected as the non-DCS group, and the patients were performed early definitive surgery, and not treated with DCS technology. The average operation time, length of stay, mortality and incidence of complicationsof two groups were compared. Results The mortality rate of the DCS group was 10.42%, which was lower than that of the non-DCS group （27.91%）. The operation time of the DCS group was lower than thal of the non-DCS group. The length of stay of the DCS group was higher than that in non DCS group, and the differences were statistically significant （P 〈0.05）. The complication rate in the DCS group was 14.58%. the complication rate in the non-DCS group was 37.21%. and there was significant difference between the two groups （P〈0.05）. Conclusion In the treatment of traumatic liver injury, based on the theory of damage control surgery, the three stage processing principle can effectively reduce the mortality rate and incidence of complications. The prognosis of patients has been significantly improved. It is worth promoting in clinical treatment.