损伤控制性手术治疗不稳定型骨盆骨折合并多发伤患者的效果

Effects of injury controlled surgery on unstable pelvic fracture patients with multiple injuries

目的:观察损伤控制性手术治疗不稳定型骨盆骨折合并多发伤患者的效果。方法:回顾性分析2018年12月至2019年12月该院收治的80例不稳定型骨盆骨折合并多发伤患者的临床资料,依据治疗方案不同分为对照组和观察组各40例。对照组给予常规手术治疗,观察组给予损伤控制性手术治疗,两组术后均随访3个月。比较两组手术相关指标(术中输血量、手术时间)水平和住院时间,入院时与确定性手术前血清降钙素原(PCT)水平、体温和血液pH值,以及并发症发生率。结果:观察组术中输血量少于对照组,手术时间和住院时间均短于对照组,差异有统计学意义(P<0.05);确定性手术前,观察组体温和血液pH值均高于对照组,血清PCT水平低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为10.00%(4/40),低于对照组的40.00%(16/40),差异有统计学意义(P<0.05)。结论:损伤控制性手术治疗不稳定型骨盆骨折合并多发伤患者,可减少术中输血量,缩短手术时间和住院时间,提高体温和血液pH值,降低血清PCT水平和术后并发症发生率,效果优于常规手术治疗。

Objective:To observe effects of injury controlled surgery on unstable pelvic fracture patients with multiple injuries.Methods:A retrospective analysis of the clinical data of 80 patients with unstable pelvic fractures and multiple injuries admitted to the hospital from December 2018 to December 2019 was performed.According to different treatment plans,they were divided into control group and observation group,each with 40 cases.The control group was given conventional surgery,while the observation group was given the injury controlled surgery.Both groups were followed up for 3 months.The operation-related indicator levels(intraoperative blood transfusion,operation time),the hospitalization time,the levels of the serum procalcitonin(PCT),body temperature,blood pH,and the incidence of complications at admission and before the definitive surgery were compared between the two groups.Results:The amount of intraoperative blood transfusion in the observation group was less than that of the control group;the operation time and the hospitalization time were shorter than those of the control group;and the differences were statistically significant(P<0.05).Before the definitive surgery,the body temperature and the blood pH of the observation group were higher than those of the control group;the serum PCT level was lower than that of the control group;and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 10.00%(4/40),which was lower than 40.00%(16/40)in the control group,and the difference was statistically significant(P<0.05).Conclusions:The injury controlled surgery for the patients with unstable pelvic fractures and multiple injuries can reduce the intraoperative blood transfusion,shorten the operation time and the hospitalization time,increase the body temperature and the blood pH,and reduce the serum PCT level and the postoperative complications.Moreover,it is superior to conventional surgery.