损伤控制理论下骨盆骨折院前与院内联合救治的效果观察

Explore the Effect of Combined Pre-hospital and In-hospital Treatment of Pelvic Fracture Under Injury Control Theory

探析损伤控制理论下骨盆骨折院前与院内联合救治的效果.方法:将2018年1月-2019年12月90例自行前往医院就诊、并采取常规院内救治的骨盆骨折患者作为对照组.另选取相同时间段内依照骨科损伤控制理论(DCO) ,由急救中心展开院前急救、在院内行多科室联合救治的90例骨盆骨折患者为观察组.所有患者都经过急诊CT确诊为骨盆骨折.对比2组治疗效果,以死亡率、并发症发生情况、远期疗效、骨折复位效果、实验室参数为研究分析指标.结果:相较于对照组,观察组死亡率更低,并发症发生率更低,骨折复位优良率更高(P<0.05);实验室参数方面:观察组复苏4小时后,PT(凝血酶原时间)和血乳酸含量少于对照组,PLT(血小板计数)和HCT(血细胞比容)高于对照组,数据对比差异明显(P<0.05);观察组远期Cole评分更高(P<0.05).结论:针对骨盆骨折患者,应用DCO理论下的院前急救与院内联合救治,能够降低患者死亡率和并发症发生率,强化治疗效果且患者远期恢复效果更优,具有临床推广应用价值.

Objective:To explore the effect of combined pre-hospital and in-hospital treatment of pelvic fracture under injury control theory.Methods:From January 2018 to December 2019,90 patients with pelvic fracture who went to the hospital by themselves and were treated in the conventional hospital were used as the control group.In the same time period,90 cases of pelvic fracture were treated by pre-hospital first aid in emergency center and combined treatment in hospital according to the theory of orthopaedic injury control(DCO).All patients were diagnosed with pelvic:fractures by emergency CT.The mortality,complications,long-term curative effect,Fracture Reduction Effect and laboratory parameters were compared between the two groups.Results:Compared with the Control Group,the observation group had lower mortality,lower complication rate and higher excellent and good rate of fracture reduction(p<O.05),plt(platelet count)and HCT(Hematocrit)were significantly higher than those of the control group(p<0.05),and the long-term Cole score was higher in the observation group(p<0.05).Conclusion:The combination of pre-hospital care and in-hospital care under the theory of DCO can reduce the morality rate and complication rate of patients with pelvic fracture,it has the value of clinical popularization and application.