损伤控制在胰腺横断并发十二指肠裂伤中的应用

Injury Control in Pancreatic Transection Complicated With Duodenal Laceration

目的探讨损伤控制性理论在外伤所致胰腺横断并发十二指肠裂伤中的临床应用价值。方法选择2015年1月—2017年12月医院收治的交通伤所致腹部急性压伤患者80例,按照是否实施损伤控制理论分为两组,各40例。对照组在明确诊断后立即实施手术干预,观察组行损伤控制理论进行干预,比较两组住院时间、住院费用,统计两组治疗期间出现的相关并发症及整体救治情况。结果观察组总住院时间短于对照组(P<0.05),入住重症监护室天数少于对照组(P<0.05),住院费用低于对照组(P<0.05),观察组发生代谢性酸中毒、凝血功能障碍、顽固性低体温及腹腔内间隙综合征的比例显著低于对照组(P<0.05),观察组痊愈出院率显著高于对照组(P<0.05),临床死亡率显著低于对照组(P<0.05)。结论针对急性胰腺横断并发十二指肠损伤者,在损伤控制理论指导下实施手术治疗干预,能显著缩短患者住院时间,减少并发症,提高救治成功率,是一种安全性高、可行性强,科学合理的救治方法。

Objective To explore the clinical application value of injury control theory in traumatic pancreatic transection and duodenal laceration.Methods 80 cases with acute abdominal cramps caused by traffic injuries from January 2015 to December 2017 were selected and divided into two groups according to whether the injury control theory was implemented.Results The total hospitalization time in the observation group was shorter than that in the control group(P<0.05),the number of days in the intensive care unit was less than the control group(P<0.05),the hospitalization cost was lower than the control group(P<0.05),and metabolic acidosis was observed in the observation group.The proportion of coagulation dysfunction,refractory hypothermia and intra-abdominal clearance syndrome was significantly lower than that of the control group(P<0.05).The hospital discharge rate was significantly higher in the observation group than in the control group(P<0.05).The clinical mortality was significantly lower than that of the control group(P<0.05).Conclusions For acute pancreatic transection complicated by duodenal injury,scientific and rational treatment methods.