下肢毁损伤分段损伤控制救治研究

Research on staged injury control and treatment of severe lower limb damages

[目的]探讨分段损伤控制在下肢毁损伤患者临床急救中的应用价值。[方法]116例下肢毁损伤患者根据急救方法的不同分为两组:研究组(64例)根据损伤控制理论实施分段治疗,对照组(52例)实施常规急救治疗。对比两组的抢救及下肢功能恢复情况。[结果]研究组的抢救成功率高于对照组,急救时间、ICU天数、平均住院时间均短于对照组(P<0.05)。急救后1个月,研究组患者的肌力、屈伸度值均显著高于对照组,膝关节僵硬、局部肿胀、局部水泡发生率均显著低于对照组(P<0.05)。研究组的并发症总发生率显著低于对照组,家属总满意率显著高于对照组(P<0.05)。[结论]分段损伤控制用于下肢毁损伤救治可有效缩短急救时间,提高急救成功率,促进下肢功能恢复。

[Objective]To explore the significance of staged injury control and treatment for severe lower extremity damages in emergency.[Methods]A total of 116 patients with severe lower extremity injuries were divided into two groups according to treatment in emergency.Of them,64 patients in the trial group received staged injury control and surgical treatment according to the theory of damage con-trol,while the remaining 52 patients in the control group underwent conventional emergent treatment.The rescue and lower limb function recovery were compared between the two groups.[Results]The trial group proved significantly higher rescue success rate,whereas significantly shorter emergency time,ICU days,and hospital stay than the control group(P<0.05).At one month after emergent surgical treatment,the trial group had significantly higher muscle strength and flexion and extension range of motion(ROM),whereas significantly lower incidence of knee stiffness,local swelling,local blisters and complication in total than the control group(P<0.05).The trial group was marked significantly higher total satisfaction rate of family members than the control group(P<0.05).[Conclusion]The use of staged injury control and surgical treatments for severe lower extremity injuries does effectively shorten the time elapsed in emergency,increase the success rate of rescue,and promote the recovery of lower extremity functions.