损伤控制在机动卫勤分队治疗战伤骨折的应用探讨

Application of damage control in the treatment of war injury fracture by mobile medical detachment

目的:探讨机动卫勤分队利用损伤控制技术处置战场严重战伤骨折的方法。方法:采用文献分析法,从高能量战伤常见骨折类型和特点、战场的处置方案及损伤控制骨科理念的特点进行分析,梳理我军现行条件下战术战伤救治阶段对战伤骨折可行的处置方案。结果:目前机动卫勤分队面临严重战伤救治有效率较低,病死率及致残率较高,预后差等问题。现行的清创、缝合、外固定、后送的战创伤救治原则有待提升。损伤控制骨科理念运用于战场救治严重战伤骨折有明显优势。结论:损伤控制骨科理念已在临床广泛使用且效果较好,在医疗水平提升及医疗设施研发的支持下,将损伤控制骨科理念与我军机动卫勤分队骨折战伤救治原则相结合,能有效提高严重创伤骨折伤员生存率,降低致残率及长时间不恰当转运中再损伤的风险,减少并发症发生,改善预后,促进功能恢复。

Objective:To evaluate the method for mobile medical detachment of dealing with severe war injury fracture by using damage control technology.Methods:Using literature analysis,the common fracture types and characteristics of high-energy war injury,the current wartime treatment plan and the characteristics of damage control orthopedics(DCO),and the feasible disposal solution of tactical war wounded under the current conditions of our army were summarized.Results:At present,the mobile medical detachment were faced with low effective treatment rate,high fatality rate and disability,and poor prognosis.The current principles of debridement,suture,external fixation and evacuation for war injury fracture need to be improved.The concept of DCO had obvious advantages in the treatment of severe war injury fracture during wartime.Conclusion:DCO has been widely used in clinical and has a good effect,with the support of the improvement of medical standards and the development of medical facilities,combining the concept of DCO with the principles of fracture by our mobile medical detachment can effectively improve the survival rate of war injury fracture,reduce the disability,the risk of re-injury in inappropriate transport for a long time and complications,and improve the prognosis,promote functional recovery.