损伤控制策略在创伤救治中的应用

目的探讨损伤控制在严重创伤患者急救中的应用效果。方法对2008年8月～2012年1月问52例严重创伤并骨折患者按损伤控制策略救治。应用损伤控制原则分三阶段治疗，早期骨折给予临时固定、清创、止血治疗，术后进入ICU监护治疗，病情平稳后行确定性手术。结果52例严重创伤患者先进行急诊手术控制出血和污染，然后给予ICU复苏，待生命体征平稳定，全身情况好转后再进行确定性手术。死亡2例，死亡率3．85％。随访1～38月，平均3．2±0．6月），并发症包括伤口感染10例，经引流、换药后愈合。骨折顺利愈合，邻近关节功能恢复佳。结论针对创伤的特点，按损伤控制策略进行救治，可提高治疗效果，减少患者死亡率。

Application of damage control technique in the treatment of serious trauma

Objective To evaluate the effect of damage control technique in the treatment of serious trauma. Methods A total of 52 patients with multiple injury concured with fracture were treated by damage control tech- nique during August 2008 to January 2012.The therapy process include three procedures： Early, granted debride- ment, hemostasis, provisional fixing fracture; Next, cared in the intensive care unit; Finally, when pathogenetic con- dition was equable, the patients received operation. The treatment outcomes were analyzed. Results 52 cases were treated by emergency operation to control the bleeding and contamination, and then resuscitation in ICU was per- formed. When the vital signs were stable, the definitive operation was performed successfully. All the patients survived after definitive operation. 2 cases died, and the mortality rate was 3.85 % in the serials. Follow up was made for 1 - 18 months with an average of 3.2 ＋ 0.6 months. There were some complications. Wound infection took place in 10 cases,and healed after drainage,change dressings etc. The fracture healed, and nearby joints＇ function recovered well. Conclusion The patients can get a good and satisfactory treatment effect basing on the ap- plication of damage control technique. And the damage control technique can decrease the mortality of the wound- ed.