Tugnoli Gregorio, Casali Marco, Villani Silvia, Biscardi Andrea, Sinibaldi Giovanni, Baldoni Franco
Chirurgia d'Urgenza e del Trauma, Ospedale Maggiore, Azienda USL Città di Bologna, Bologna.
Ann Ital Chir. 2007 Mar-Apr;78(2):81-4.
To evaluate our experience in the treatment of complex abdominal injuries with the principles of Damage Control Surgery (DCS).
A retrospective review was conducted of 55 patients with multiple abdominal injuries and severe haemorrhage induced hypothermia and acidosis admitted to the "Ospedale Maggiore Trauma Center" in Bologna from 1989 to June 2005.
All the patients but one had major blunt trauma. Mean age was 40.1; mean ISS 42; mean RTS 4.11; extimated loss of blood was greater than 4000 ml. Packing provide definitive control of bleeding in 44 patients but 10 had recurrent bleeding or bleeding from different injuries such as bone fractures and required further surgery (2) or arterial embolization (8). Twenty eights patients (50.9%) died. Survival was strongly associated with the ISS, GCS, the loss of blood and acidosis.
The Authors concluded that in selected circumstances the traditional approach to severe abdominal injuries is not appropiate. In this situation, alternative and aggressive treatment such as the Damage Control Surgery has been recommended as the procedure of choice.
评估我们运用损伤控制外科（DCS）原则治疗复杂腹部损伤的经验。
对1989年至2005年6月期间收治于博洛尼亚“马焦雷医院创伤中心”的55例腹部多发伤且因严重出血导致体温过低和酸中毒的患者进行回顾性研究。
除1例患者外，所有患者均遭受严重钝性创伤。平均年龄为40.1岁；平均损伤严重度评分（ISS）为42分；平均创伤评分（RTS）为4.11分；估计失血量超过4000毫升。填塞术使44例患者出血得到有效控制，但10例患者出现复发出血或因骨折等不同损伤部位出血，需要进一步手术治疗（2例）或动脉栓塞治疗（8例）。28例患者（50.9%）死亡。生存与ISS、格拉斯哥昏迷评分（GCS）、失血量和酸中毒密切相关。
作者得出结论，在特定情况下，传统的严重腹部损伤治疗方法并不合适。在这种情况下，建议采用如损伤控制外科等替代且积极的治疗方法作为首选方案。
