CAJ | 학술논문

目的探讨损伤控制理论对严重多发伤并发症早期控制的临床效果.方法回顾性分析2006年1月至2008年1月武汉市同济医院收治的116例严重多发伤患者,依据救治方式分为损伤控制组(55例)和常规方式组(61例),对两组患者的手术持续时间、术后休克和"致死性三联征(LTD)"的纠正情况、术后并发症和预后情况进行统计学分析,比较损伤控制手术和常规确定性手术对严重多发伤患者并发症的早期控制情况.结果采用两种不同救治方式后,损伤控制组手术持续时间为(67.43±19.52)min,休克和"致死性三联征"纠正时间分别为(6.77±3.16)h和(11.54±4.10)h,常规方式组手术持续时间为(163.95±55.41)win,休克和"致死性三联征"纠正时间分别为(22.51±11.65)h和(34.55±5.63)h,两组间差异具有统计学意义(P<0.01);损伤控制组并发症人均发生率和病死率分别为227.27%和3.64%,常规方式组并发症人均发生率和病死率分别为363.93%和9.84%,差异具有统计学意义(P<0.05).结论在严重多发伤救治中早期应用损伤控制理论能显著缩短手术时间,早期纠正休克和LTD,减少术后并发症的发生,降低病死率.
목적 탐토손상공제이론대엄중다발상병발증조기공제적림상효과.방법 회고성분석2006년1월지2008년1월무한시동제의원수치적116례엄중다발상환자,의거구치방식분위손상공제조(55례)화상규방식조(61례),대량조환자적수술지속시간、술후휴극화"치사성삼련정(LTD)"적규정정황、술후병발증화예후정황진행통계학분석,비교손상공제수술화상규학정성수술대엄중다발상환자병발증적조기공제정황.결과 채용량충불동구치방식후,손상공제조수술지속시간위(67.43±19.52)min,휴극화"치사성삼련정"규정시간분별위(6.77±3.16)h화(11.54±4.10)h,상규방식조수술지속시간위(163.95±55.41)win,휴극화"치사성삼련정"규정시간분별위(22.51±11.65)h화(34.55±5.63)h,량조간차이구유통계학의의(P<0.01);손상공제조병발증인균발생솔화병사솔분별위227.27%화3.64%,상규방식조병발증인균발생솔화병사솔분별위363.93%화9.84%,차이구유통계학의의(P<0.05).결론 재엄중다발상구치중조기응용손상공제이론능현저축단수술시간,조기규정휴극화LTD,감소술후병발증적발생,강저병사솔.
Objective To analyze the efficacy of early management of eomplications in patients with multi-ple traumas by applying the damage control theory. Method All total of 116 patients admitted to Wuhan Tongji Hospital between Jan 2006 and Jan 2008 were included in this retrospective study and were classified according to treatment method. Overall, 55 cases underwent damage control operations and 61 cases underwent conventional management. The groups of patients were compared in terms of parameters such as length of operation time, time to resuscitate from shock, lethal triad of death (LTD), complications and treatment outcomes after operation. Results The length of operation time was (67.43±19.52) min, resuscitation time from shock was (6.77±3.16) h and LTD was (11.54±4.10) h in the damage control group, and (163.95±55.41) min, (22.51±11.65) h and (34.55±5.63) h, respectively, in the conventional group, with significant differences between the two groups (P< 0.01). The per capita complication and mortality rates were 227.27 % and 3.64 %, respectively, in the dam-age control group and 363.93 % and 9.84%, respectively, in the conventional group (P <0.05). Couclusions Here, we demonstrated that early management of patients with multiple traumas undergoing operations by apply-ing the damage control theory significantly decreased the operation time, and decreased time to resuscitation from shock and LTD. Furthermore, this approach significantly reduced the incidence of comphcations and the mortality rate of patients with severe multiple traumas.