损伤控制外科技术在严重创伤急救中的应用
创伤；损伤控制；手术,,创伤；损伤控制；手术,关键词：创伤；损伤控制；手术,临床资料,1一般资料,2救治程序,3DCS适应证的选择和优先,4监测指标和统计学,5讨论,参考文献：
摘要： 目的 探讨损伤控制外科技术(DCS)在严重创伤急救中的应用效果。方法 对2003年7月~2005年6月应用DCS救治的82例严重多发伤的临床资料进行回顾性分析。结果 对82例严重多发伤均立即给予液体复苏、急诊手术控制出血和污染，待生命体征稳定后，再行确定性手术治疗。70例经应用DCS后，休克逐渐得到纠正，再次行确定性手术，经过顺利，情况良好。复苏期患者pH、体温、PT值与一般腹腔损伤病人相比，无显著性差异。本组70例痊愈出院，12例死于脑疝或多器官衰竭。结论 对严重创伤病人，在复苏同时应尽快采用简单省时的手术控制出血和污染。病情稳定后再做相应的手术和治疗，可提高严重创伤的抢救成功率。关键词：创伤；损伤控制；手术
Effect of damage control surgery in emergency of severe traumas
YAN Baigang,XU Shiwei,WAN Zhonggeng,et al.
(Department of Emergency,Third People's Hospital of Chongqing,Chongqing 400014,China)
Abstract： Objective To study the effect of Damage Control Surgery(DCS) in the treatment of severe traumas.Methods A retrospective analysis was made on the clinical data of 82 case with multiple injuries treated by DCS form 2003 to 2005.Results Eigtytwo cases of severe multiple injury were treated by immediate fluid resuscitation and emergency operation,so that to control the bleeding and contamination.The definitive operation was operated as soon as the vital signs became stable in EICU.Bleeding and contamination were controlled after emergency DCS,and traumatic shock was controlled in 70 cases.The definitive operation was operated successfully.Seventy cases survived.The body temperature,serum pH and prothrombin time(PT) level of patients during resuscitation in EICU were not significantly different from those of abdominal traumas.Twelve cases dead of cerebral hernia or multiple organ failure.Conclusion The successful operative control of bleeding and contemination while resuscitation and definitive operation performed will contribute a lot to a high curative rate. ......
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