早期损伤控制复苏联合多学科协作急救模式对血流动力学不稳定型骨盆骨折病人疗效的影响

Effect of early injury control resuscitation combined with multidisciplinary collaborative emergency mode on the efficacy of patients with hemodynamically unstable pelvic fractures

目的:探讨多学科协作急救模式联合早期损伤控制复苏治疗血流动力学不稳定型骨盆骨折的疗效。方法:选取实施多学科协作急救模式联合早期损伤控制复苏的血流动力学不稳定型骨盆骨折病人30例作为观察组,并选取观察组模式实施前行传统积极液体复苏的血流动力学不稳定型骨盆骨折病人30例作为对照组。统计分析2组病人24 h内胶体液、晶体液、血浆和浓缩红细胞的输注量,体温恢复、凝血功能恢复及乳酸清除时间,弥散性血管内凝血(DIC)发生率及死亡率。结果:观察组无胶体液补充。观察组病人晶体液和浓缩红细胞输注量均低于对照组,而血浆输注量高于对照组,体温恢复、凝血功能恢复及乳酸清除时间均短于对照组,差异均有统计意义(P<0.01);研究组DIC发生率为3.33%,死亡率为6.67%与对照组的10.00%和16.67%,差异均无统计意义(P>0.05)。结论:多学科协作急救模式联合早期损伤控制复苏应用于血流动力学不稳定型骨盆骨折,能够快速、有效地恢复病人血流动力学稳定状态。

Objective:To explore the efficacy of multidisciplinary collaborative emergency mode combined with early injury control resuscitation in the treatment of hemodynamically unstable pelvic fractures.Methods:A total of 30 patients with hemodynamically unstable pelvic fractures who implemented multidisciplinary collaborative emergency mode combined with early injury control resuscitation were selected as the observation group,and 30 patients with hemodynamically unstable pelvic fractures who implemented traditional active fluid resuscitation before the observation group mode were selected as the control group.The infusion volume of colloidal solution,crystal solution,plasma,and concentrated red blood cells within 24 hours,recovery of body temperature,coagulation function,and lactate clearance time,as well as the incidence and mortality rate of disseminated intravascular coagulation(DIC)of patients in the two groups were statistically analyzed.Results:There was no colloidal solution supplementation in the observation group.The infusion volume of crystal fluid and concentrated red blood cells in the observation group were lower than those in the control group,while the plasma infusion volume was higher than that in the control group,the recovery time of body temperature,coagulation function,and lactate clearance were shorter than those in the control group,and the differences were statistically significant(P<0.01).The incidence of DIC in the observation group was 3.33%,and the mortality rate was 6.67%,which was not statistically significant compared to 10.00% and 16.67% in the control group(P>0.05).Conclusions:The multidisciplinary collaborative emergency mode combined with early injury control resuscitation applied to hemodynamically unstable pelvic fractures can quickly and effectively restore the patient's hemodynamically stable state.