Böhme J, Höch A, Gras F, Marintschev I, Kaisers U X, Reske A, Josten C
Klinik für Unfall-, Wiederherstellungs- und plastische Chirurgie, Universitätsklinikum Leipzig AöR, Liebigstraße 20, 04103, Leipzig, Deutschland,
Unfallchirurg. 2013 Oct;116(10):923-30. doi: 10.1007/s00113-012-2237-5.
The aim of this study was to investigate the influence of the surgical timing in patients with pelvic fractures and severe chest trauma on the clinical course, especially on postoperative lung function.
A total of 47 patients were included in a prospective dual observational study. The study investigated the clinical course depending on the time of operation based on the functional lung parameters, SAPS II, SOFA and total hospital stay.
The average ISS was 32±6, PTS was 34±11 and TTSS was 9±3 points. The pelvic fractures were stabilized definitively after an average of 7±2 days. The early stabilization correlated significantly with a lower TTSS and SAPS II on admission (p<0.05), shorter time of ventilation (p<0.05) and stay in the intensive care unit (p<0.01) as well as the decreased need for packed red blood cells (p<0.01).
In this study patients with pelvic fractures and thoracic trauma benefited positively from an earlier definitive pelvic fracture stabilization with respect to a shorter time of ventilation and stay in the intensive care unit due to a lower need for red cell concentrates.
本研究旨在探讨骨盆骨折合并严重胸部创伤患者的手术时机对临床病程的影响，尤其是对术后肺功能的影响。
一项前瞻性双盲观察性研究共纳入47例患者。该研究根据功能性肺参数、简化急性生理学评分II（SAPS II）、序贯器官衰竭评估（SOFA）和总住院时间，依据手术时间调查临床病程。
平均损伤严重度评分（ISS）为32±6分，骨盆创伤评分（PTS）为34±11分，创伤和损伤严重度评分（TTSS）为9±3分。骨盆骨折平均在7±2天后得到确切固定。早期固定与入院时较低的TTSS和SAPS II显著相关（p<0.05），通气时间较短（p<0.05），在重症监护病房的停留时间较短（p<0.01），以及浓缩红细胞需求量减少（p<0.01）。
在本研究中，骨盆骨折合并胸部创伤的患者因红细胞浓缩物需求量较低，早期进行确切的骨盆骨折固定，在缩短通气时间和在重症监护病房的停留时间方面有积极获益。
