中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
22期
73-75
,共3页
罗军%左建文%唐旭华%孙仲寅%宋刚
囉軍%左建文%唐旭華%孫仲寅%宋剛
라군%좌건문%당욱화%손중인%송강
骨科损伤控制%骨盆骨折%急性呼吸窘迫综合征
骨科損傷控製%骨盆骨摺%急性呼吸窘迫綜閤徵
골과손상공제%골분골절%급성호흡군박종합정
Damage-control orthopedics%Pelvic fracture%Acute respiratory distress syndrome
目的：探讨骨科损伤控制(DCO)治疗严重骨盆骨折的临床效果。方法回顾性分析本院2010年1月~2014年1月收治的201例严重骨盆骨折患者临床资料,其中采用DCO治疗的患者为试验组(n=104),未采用DCO治疗的患者为对照组(n=97),观察两组的院内死亡率、手术时间、术中失血量、术中输液总量、术后并发症发生率和6 h乳酸清除率。结果试验组、对照组分别有7例(6.7%)和22例(22.7%)死亡,死亡原因均为失血性休克和多器官功能不全综合征,两组院内死亡率比较差异有统计学意义(P=0.003)。试验组的手术时间显著短于对照组[(55.7±11.2)min vs (121.5±21.3) min,P=0.012)；试验组的术中出血量、术中输液总量均显著少于对照组[(250.3±54.3)ml vs(612.5±56.7)ml,(4613.9±1135.4)ml v s (8821.3±2030.4)ml,P=0.008、0.006)]。试验组、对照组术后并发症发生率分别为17.3%和24.7%,两组比较,差异无统计学意义(P=0.262)。试验组的急性呼吸窘迫综合征发生率显著低于对照组(P=0.038)。试验组、对照组术后6 h乳酸清除率分别为21.3%和11.2%,两组比较,差异有统计学意义(P=0.004)。结论 DCO有助于提高严重骨盆骨折患者的生存率、降低急性呼吸窘迫综合征发生率。
目的：探討骨科損傷控製(DCO)治療嚴重骨盆骨摺的臨床效果。方法迴顧性分析本院2010年1月~2014年1月收治的201例嚴重骨盆骨摺患者臨床資料,其中採用DCO治療的患者為試驗組(n=104),未採用DCO治療的患者為對照組(n=97),觀察兩組的院內死亡率、手術時間、術中失血量、術中輸液總量、術後併髮癥髮生率和6 h乳痠清除率。結果試驗組、對照組分彆有7例(6.7%)和22例(22.7%)死亡,死亡原因均為失血性休剋和多器官功能不全綜閤徵,兩組院內死亡率比較差異有統計學意義(P=0.003)。試驗組的手術時間顯著短于對照組[(55.7±11.2)min vs (121.5±21.3) min,P=0.012)；試驗組的術中齣血量、術中輸液總量均顯著少于對照組[(250.3±54.3)ml vs(612.5±56.7)ml,(4613.9±1135.4)ml v s (8821.3±2030.4)ml,P=0.008、0.006)]。試驗組、對照組術後併髮癥髮生率分彆為17.3%和24.7%,兩組比較,差異無統計學意義(P=0.262)。試驗組的急性呼吸窘迫綜閤徵髮生率顯著低于對照組(P=0.038)。試驗組、對照組術後6 h乳痠清除率分彆為21.3%和11.2%,兩組比較,差異有統計學意義(P=0.004)。結論 DCO有助于提高嚴重骨盆骨摺患者的生存率、降低急性呼吸窘迫綜閤徵髮生率。
목적：탐토골과손상공제(DCO)치료엄중골분골절적림상효과。방법회고성분석본원2010년1월~2014년1월수치적201례엄중골분골절환자림상자료,기중채용DCO치료적환자위시험조(n=104),미채용DCO치료적환자위대조조(n=97),관찰량조적원내사망솔、수술시간、술중실혈량、술중수액총량、술후병발증발생솔화6 h유산청제솔。결과시험조、대조조분별유7례(6.7%)화22례(22.7%)사망,사망원인균위실혈성휴극화다기관공능불전종합정,량조원내사망솔비교차이유통계학의의(P=0.003)。시험조적수술시간현저단우대조조[(55.7±11.2)min vs (121.5±21.3) min,P=0.012)；시험조적술중출혈량、술중수액총량균현저소우대조조[(250.3±54.3)ml vs(612.5±56.7)ml,(4613.9±1135.4)ml v s (8821.3±2030.4)ml,P=0.008、0.006)]。시험조、대조조술후병발증발생솔분별위17.3%화24.7%,량조비교,차이무통계학의의(P=0.262)。시험조적급성호흡군박종합정발생솔현저저우대조조(P=0.038)。시험조、대조조술후6 h유산청제솔분별위21.3%화11.2%,량조비교,차이유통계학의의(P=0.004)。결론 DCO유조우제고엄중골분골절환자적생존솔、강저급성호흡군박종합정발생솔。
Objective To explore the clinical effect of damage-control orthopedics (DCO) in the treatment of severe pelvic fracture. Methods Clinical data from 201 patients with severe pelvic fracture from January 2010 to January 2014 were retrospectively analyzed.Patients applied DCO was classified into experimental group (n=104),and those who didn’t were categorized into control group (n=97).The hospital mortality,operative time,intraoperative amount of bleeding,intra-operative amount of transfusion,incidence rate of postoperative complication,and lactate clearance rate of 6-hour in two groups was observed respectively. Results There were 7 (6.7%) and 22 (22.7%) dead cases in experimental group and control group And the causes of death were hemorrhagic shock and multiple organ dysfunction syndrome.The hospital mortality between two groups displayed a statistical difference (P=0.003).The operative time in experimental group [(55.7±11.2) min] was obviously shorter than that in control group [(121.5±21.3) min] (P=0.012).In experimental group, the intraoperative amount of bleeding and amount of transfusion during surgery [(250.3±54.3) ml and (4613.9±1135.4) ml] in control group,and it was (612.5±56.7) ml and (8821.3±2030.4) ml respectively.After comparison,the two indexes in experimental group was obviously less than that in control group (P=0.00,0.006).The incidence rate of postoperative complication in experimental group and control group was 17.3% and 24.7% respectively,which didn’t display a statis-tical difference (P=0.262).The incidence rate of acute respiratory distress syndrome (ARDS) in experimental group was obviously lower than that in control group (P=0.038).The lactate clearance rate of 6-hour after surgery was 21.3% and 11.2% in the experimental group and control group with a statistical difference (P=0.004). Conclusion DCO is benefi-cial to improve the survival rate of patients with severe pelvic fracture and reduce the incidence of ARDS.
