CAJ | 학술논문

目的探讨损伤控制(damage control,DC)理念在救治严重肝脏创伤中的临床应用.方法通过回顾性分析2003年4月-2010年4月采用损伤控制理念救治出现血流动力学不稳定、低体温、代谢性酸中毒和凝血障碍等情况的20例严重肝脏创伤(Ⅲ～Ⅵ级)患者的临床资料,总结出应用损伤控制理念救治严重肝创伤的适应证、并发症和死亡率.结果20例患者中痊愈16例(治愈率80%),死亡4例(死亡率为20%),术后共10例发生各种并发症(占50%).结论对于严重肝脏创伤出现血流动力学不稳、低体温、代谢性酸中毒和凝血障碍等情况时选择损伤控制策略不失为比较安全、稳妥的救治方法,可有效地降低严重肝脏创伤的死亡率和并发症发生率.
목적 탐토손상공제(damage control,DC)이념재구치엄중간장창상중적림상응용.방법 통과회고성분석2003년4월-2010년4월채용손상공제이념구치출현혈류동역학불은정、저체온、대사성산중독화응혈장애등정황적20례엄중간장창상(Ⅲ～Ⅵ급)환자적림상자료,총결출응용손상공제이념구치엄중간창상적괄응증、병발증화사망솔.결과20례환자중전유16례(치유솔80%),사망4례(사망솔위20%),술후공10례발생각충병발증(점50%).결론대우엄중간장창상출현혈류동역학불은、저체온、대사성산중독화응혈장애등정황시선택손상공제책략불실위비교안전、은타적구치방법,가유효지강저엄중간장창상적사망솔화병발증발생솔.
Objective To discuss the clinical application of damage control (DC)in the treatment of severe liver trauma. Methods A retrospective study was done to analyze the clinical data of 28patients with severe liver trauma ( Ⅲ-Ⅵ degree) who had the complications of hemodynamic instability,hypothermia, metabolic acidosis and blood coagulation disturbance and were treated with DC from April 2003 to April 2010 to sum up the operation indication, complications and mortality rate of DC. Results Of all the patients, 16 patients were cured and four died, with cure rate of 80% and mortality rate of 20%. Ten patients (50%) had complications after operation. Conclusions For the patients with severe liver trauma, DC is a safe and reliable operation method and can effectively lower complications and mortality rate when there appear hemodynamic instability, hypothermia, metabolic acidosis and blood coagulation disturbance complications.