损伤控制策略在骨折合并多发性创伤患者的急诊救治效果

Analysis of Emergency Treatment Outcomes in Patients with Fractures and Multiple Trauma

目的探索损伤控制策略在骨折合并多发性创伤患者急救中的应用价值。方法纳入2021年6月至2023年6月湖北省襄阳市谷城县人民医院收治的90例骨折合并多发性创伤患者,分为研究组与对照组,研究组采取损伤控制策略下的急救策略,对照组采取常规骨折救治策略,每组各45例。比较两组患者的住院时间和骨折愈合时间,以及治疗前后损伤严重度评分(Injury Severity Score,ISS)、系统炎性反应评分(Systemic Inflammatory Response Syndrome Score,SIR)、格拉斯哥昏迷评分(Glasgow Coma Scale,GCS),关注急性呼吸窘迫综合征(Acute Respiratory Distress Syndrome,ARDS)和多器官功能障碍不全(Multiple Organ Dysfunction,MODS)并发症的发生率以及死亡率。结果研究组住院时间和骨折愈合时间均显著短于对照组(P<0.001)。治疗前,两组患者ISS评分、SIR评分、GCS评分无显著差异(P>0.05);治疗后,两组患者ISS评分、SIR评分、GCS评分均显著降低(P<0.05),且研究组降低更显著(P<0.001)。研究组患者MODS发生率、ARDS发生率、病死率均显著低于对照组(P<0.05)。结论损伤控制理论在骨折合并多发性创伤患者中,能够有效缩短住院时间和骨折愈合时间,改善损伤程度,降低患者并发症的发生率和死亡率。

Objective To explore the application value of injury control strategy in the emergency treatment of fractures combined with multiple traumas.Methods 90 patients with fractures combined with multiple traumas who visited the People's Hospital of Gucheng County,Xiangyang City,Hubei Province from June 2021 to June 2023 were included and divided into the study group(n=45)and the control group(n=45).The study group adopted emergency treatment strategy under injury control strategy,while the control group adopted routine fracture treatment strategy.The length of hospital stay,fracture healing time,ISS score,SIR score,GCS score before and after treatment,incidence of ARDS and MODS complications,and mortality rate were compared between the two groups.Results The length of hospital stay and fracture healing time in the study group were significantly shorter than those in the control group(P<0.001).Before treatment,there was no significant difference in ISS score,SIR score,and GCS score between the two groups(P>0.05);after treatment,the ISS score,SIR score,and GCS score of both groups were significantly decreased(P<0.05),with the reductionbeing more significant in the study group(P<0.001).The incidence rates of MODS,ARDS,and mortality in the study group were significantly lower than those in the control group(P<0.05).Conclusion The injury control strategycan effectively shorten the length of hospital stay and fracture healing time,improve the degree of injury,and reduce the incidence of complications and mortality in patients with fractures combined with multiple traumas.