Bose D, Tejwani N C
New York University Medical Center, 550 First Avenue, New York, NY 10016, USA.
Injury. 2006 Jan;37(1):20-8. doi: 10.1016/j.injury.2005.06.054. Epub 2005 Nov 2.
Management of polytrauma patients has changed considerably in recent years. This is in keeping with the developments that have occurred in the fields of fracture fixation techniques and intensive care. Prior to the 1970s, patients with multiple injuries were treated non-operatively, as it was believed that they were too ill to withstand surgery. Around this time, literature appeared to suggest that these patients had high rates of complications as a result of prolonged recumbency. Fracture fixation techniques were also developing rapidly, and these events led to the advent of early fracture stabilisation of multiply injured patients, known as early total care. In the following decade, the surgical world came to recognise that early stabilisation of skeletal injuries produced poor results in certain patients. The concept of 'damage control' surgery was introduced for multiply injured patients. The current era may give way to new methods as our understanding of the pathophysiology of polytrauma improves.
近年来，多发伤患者的治疗方式发生了很大变化。这与骨折固定技术和重症监护领域的发展相一致。在20世纪70年代之前，多发伤患者接受非手术治疗，因为人们认为他们病情太重，无法承受手术。大约在这个时候，文献似乎表明，这些患者由于长期卧床而出现并发症的几率很高。骨折固定技术也在迅速发展，这些情况导致了对多发伤患者进行早期骨折稳定治疗的出现，即所谓的早期全面治疗。在接下来的十年里，外科界开始认识到，在某些患者中，早期稳定骨骼损伤的效果不佳。于是引入了针对多发伤患者的“损伤控制”手术概念。随着我们对多发伤病理生理学的理解不断提高，当前时代可能会让位于新的方法。
