外伤性肝脾损伤急救手术方法的应用价值(1)
【摘要】目的：探讨外伤性肝脾损伤急救手术方法的应用价值。方法：采用回顾性分析法，选择2015年9月到2018年5月北京红十字会急诊抢救中心收治的外伤性肝脾损伤患者92例为研究对象，根据手术方法的不同分为控制组50例与手术组42例，手术组采用常规手术治疗，控制组给予损伤控制外科手术治疗，记录两组围手术指标与术后并发症发生情况。结果：所有患者都完成治疗，控制组的手术时间、术中出血量、术后下床活动時间与住院时间都显著少于手术组(P<0.05)。控制组术后14d的感染、出血、肝周脓肿、肠梗阻、急性胰腺炎等并发症发生率为4.0%，显著低于对照组的23.8%(P<0.05)。结论：相对急诊手术，外伤性肝脾损伤急救中采用损伤控制外科手术能减少对患者的创伤，降低术后并发症的发生，促进患者康复。
【关键词】急诊手术;外伤性肝脾损伤;损伤控制外科手术;并发症
[Abstract]Objective： To investigate the application value of emergency surgery for traumatic hepatic and spleen injury. Methods： From September 2015 to May 2018， Used a retrospective analysis method ， 92 patients with traumatic hepatic and spleen injury admitted to beijing red cross emergency rescue center were selected and were divided into the 50 patients in the control group and 42 patients in the the operation group， the operation group were treated with conventional surgery， and the control group were given surgical treatment for injury control. The perioperative indexes and postoperative complications of the two groups were recorded. Results： All patients were completed the treatment. The operation time， intraoperative blood loss， postoperative outpatient activity time and hospitalization time in the control group were significantly less than those in the operation group (P<0.05). The postoperative 3 months of incidences of complications such as infection， hemorrhage， perihepatic abscess， intestinal obstruction and acute pancreatitis were 4.0% in the control group which were significantly lower than that in the control group (23.8%) (P<0.05). Conclusion： Compare with emergency surgery， injury-controlled surgery in traumatic liver and spleen injury can reduce trauma to patients， reduce postoperative complications and promote rehabilitation.
, http://www.100md.com
[Key words]Emergency surgery; traumatic liver and spleen injury; injury control surgery; complications
【中图分类号】R249【文献标识码】A 【文章编号】2095-6851(2019)06-041-01
肝脾都是人体重要的器官，也是腹内脏器中最容易受损伤的器官，特别是外伤性肝胆胰脾损伤占有较高比率[1]。该病患者的病情一般都比较危重，常伴发失血性休克，早期及时明确诊断、并及时采取有效的治疗措施对改善患者的预后具有重要价值[2]。手术为该病的主要治疗方法，但是很多基础病情危重，再加上手术创伤可增加患者病情加重的几率，也增加患者术后出现感染、出血等并发症，特别是代谢性酸中毒以及凝血功能障碍均可在一定程度上增加患者的死亡率[3]。损伤控制外科手术是对患者先给予简捷操作以维持患者稳定的生理状态，在控制患者病情发展后再进行手术治疗[4]。本文具体探讨了外伤性肝脾损伤急救手术方法的应用价值，以明确损伤控制外科手术的应用价值。现总结报道如下。
, http://www.100md.com
1 资料与方法
1.1 一般资料
采用回顾性分析法，选择2015年9月到2018年5月北京红十字会急诊抢救中心收治的外伤性肝脾损伤患者92例为研究对象，纳入标准：患者或者直系家属知情同意本研究;均符合外伤性肝脾损伤;医院伦理委员会批准了此次研究;临床与随访资料完整;手术期间无死亡发生。排除标准：合并严重的心脑血管、肝肾肺等器官组织疾病患者;妊娠与哺乳期妇女患者;精神障碍、恶性肿瘤患者。
根据手术方法的不同分为控制组50例与手术组42例，两组患者的损伤类型、致伤原因、性别、年龄、就诊时间等对比差异无统计学意义(P>0.05)。见表1。, http://www.100md.com(梁智 贾伟涛 李集兵)
【关键词】急诊手术;外伤性肝脾损伤;损伤控制外科手术;并发症
[Abstract]Objective： To investigate the application value of emergency surgery for traumatic hepatic and spleen injury. Methods： From September 2015 to May 2018， Used a retrospective analysis method ， 92 patients with traumatic hepatic and spleen injury admitted to beijing red cross emergency rescue center were selected and were divided into the 50 patients in the control group and 42 patients in the the operation group， the operation group were treated with conventional surgery， and the control group were given surgical treatment for injury control. The perioperative indexes and postoperative complications of the two groups were recorded. Results： All patients were completed the treatment. The operation time， intraoperative blood loss， postoperative outpatient activity time and hospitalization time in the control group were significantly less than those in the operation group (P<0.05). The postoperative 3 months of incidences of complications such as infection， hemorrhage， perihepatic abscess， intestinal obstruction and acute pancreatitis were 4.0% in the control group which were significantly lower than that in the control group (23.8%) (P<0.05). Conclusion： Compare with emergency surgery， injury-controlled surgery in traumatic liver and spleen injury can reduce trauma to patients， reduce postoperative complications and promote rehabilitation.
, http://www.100md.com
[Key words]Emergency surgery; traumatic liver and spleen injury; injury control surgery; complications
【中图分类号】R249【文献标识码】A 【文章编号】2095-6851(2019)06-041-01
肝脾都是人体重要的器官，也是腹内脏器中最容易受损伤的器官，特别是外伤性肝胆胰脾损伤占有较高比率[1]。该病患者的病情一般都比较危重，常伴发失血性休克，早期及时明确诊断、并及时采取有效的治疗措施对改善患者的预后具有重要价值[2]。手术为该病的主要治疗方法，但是很多基础病情危重，再加上手术创伤可增加患者病情加重的几率，也增加患者术后出现感染、出血等并发症，特别是代谢性酸中毒以及凝血功能障碍均可在一定程度上增加患者的死亡率[3]。损伤控制外科手术是对患者先给予简捷操作以维持患者稳定的生理状态，在控制患者病情发展后再进行手术治疗[4]。本文具体探讨了外伤性肝脾损伤急救手术方法的应用价值，以明确损伤控制外科手术的应用价值。现总结报道如下。
, http://www.100md.com
1 资料与方法
1.1 一般资料
采用回顾性分析法，选择2015年9月到2018年5月北京红十字会急诊抢救中心收治的外伤性肝脾损伤患者92例为研究对象，纳入标准：患者或者直系家属知情同意本研究;均符合外伤性肝脾损伤;医院伦理委员会批准了此次研究;临床与随访资料完整;手术期间无死亡发生。排除标准：合并严重的心脑血管、肝肾肺等器官组织疾病患者;妊娠与哺乳期妇女患者;精神障碍、恶性肿瘤患者。
根据手术方法的不同分为控制组50例与手术组42例，两组患者的损伤类型、致伤原因、性别、年龄、就诊时间等对比差异无统计学意义(P>0.05)。见表1。, http://www.100md.com(梁智 贾伟涛 李集兵)