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[骨盆骨折多发伤患者的损伤控制手术。是否可以使用内固定?]

[Damage Control Surgery in Polytrauma Patients with Pelvic Fractures. Is It Possible to Use Internal Fixation?].

作者信息

Havlůj L, Džupa V, Gürlich R

机构信息

Chirurgická klinika 3. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady v Praze.

出版信息

Acta Chir Orthop Traumatol Cech. 2017;84(4):304-308.

Abstract

Current polytrauma management is multidisciplinary, with Damage Control Surgery (DCS), Damage Control Orthopaedics (DCO) and Damage Control Resuscitation (DCR) being applied in the first few hours after injury. The most severe group of polytrauma patients are those with circulatory instability and massive blood loss as a consequence of unstable pelvic fractures. In treating these patients, of crucial importance is the speed and quality of stabilisation of pelvic fracture fragments. The authors present two case reports of polytrauma patients with unstable pelvic fractures, in whom open reduction and internal fixation was performed on the anterior fracture segment through extended laparotomy in order to stop bleeding into the abdominopelvic cavity as part of the DCS approach. Key words: exsanguination, polytrauma, unstable pelvic fracture, plate fixation.

摘要

当前的多发伤管理是多学科的,损伤控制外科(DCS)、损伤控制骨科(DCO)和损伤控制复苏(DCR)在受伤后的最初几个小时内应用。最严重的多发伤患者是那些因骨盆骨折不稳定而出现循环不稳定和大量失血的患者。在治疗这些患者时,骨盆骨折碎片稳定的速度和质量至关重要。作者介绍了两例多发伤合并不稳定骨盆骨折患者的病例报告,作为DCS方法的一部分,通过扩大剖腹术对前骨折段进行切开复位内固定,以阻止血液流入腹腔盆腔。关键词:失血、多发伤、不稳定骨盆骨折、钢板固定。

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