Zhu Teng-Fei, Zhao Wen-Guo, Zheng Han-Lin, Wu Jia-Xiang
Department of Surgery, the North China University of Science and Technology Affiliated Hospital, Tangshan 063000, Hebei, China;
Zhongguo Gu Shang. 2018 Feb 25;31(2):145-149. doi: 10.3969/j.issn.1003-0034.2018.02.010.
To investigate the application effect of damage control orthopedics for the treatment of severe multiple fractures.
From January 2014 to December 2016, 23 patients with severe multiple fractures were treated with the damage control orthopedics (DCO), included 14 males and 9 females with an average age of (41.57±8.29) years old ranging from 28 to 60 years old; the NISS averaged(27.70±5.44) points ranging from 18 to 40 points. As the control group, 27 patients with severe multiple fractures were treated by the early total care(ETC) technology from Jan. 2007 to Dec. 2019, included 16 males and 11 females with an average age of (38.33±9.99) years old ranging from 19 to 55 years old, the NISS averaged (31.07±6.46) points ranging from 20 to 43 points. The ICU recovery time, blood transfusion, total operation time, mortality, complication and length of hospital stay were observed and compared between two groups.
In the DCO group, there were 22 cases surviving and 1 case death, 3 cases of postoperative complication contained 2 cases of adult respiratory distress syndrome, 1 case pin of infection in external fixation. In ETC group, there were 25 cases surviving and 2 cases death, 10 cases of postoperative complication contained 4 cases of adult respiratory distress syndrome and 3 cases of pin infection in external fixation, 1 case of wound infection and 2 cases of multiple organ failure. There was statistically significant difference between two groups in blood transfusion in operation, the ICU recovery time, and complications(<0.05). There was no statistically significant difference in total operation time, length of hospital stay and mortality between two groups(>0.05).
For patients with severe multiple fractures, application of damage control orthopedics can significantly reduce the postoperative complications, ICU recovery time and intraoperative blood transfusion, provide a certain basis for clinical treatment of such patients.
探讨损伤控制骨科在严重多发骨折治疗中的应用效果。
选取2014年1月至2016年12月采用损伤控制骨科（DCO）治疗的23例严重多发骨折患者，其中男14例，女9例，平均年龄（41.57±8.29）岁，年龄范围28～60岁；创伤严重程度评分（NISS）平均（27.70±5.44）分，范围18～40分。选取2007年1月至2019年12月采用早期全面治疗（ETC）技术治疗的27例严重多发骨折患者作为对照组，其中男16例，女11例，平均年龄（38.33±9.99）岁，年龄范围19～55岁，NISS平均（31.07±6.46）分，范围20～43分。观察并比较两组患者重症监护病房（ICU）恢复时间、输血量、总手术时间、死亡率、并发症及住院时间。
DCO组存活22例，死亡1例，术后并发症3例，其中成人呼吸窘迫综合征2例，外固定针感染1例。ETC组存活25例，死亡2例，术后并发症10例，其中成人呼吸窘迫综合征4例，外固定针感染3例，伤口感染1例，多器官功能衰竭2例。两组患者手术中的输血量、ICU恢复时间及并发症差异有统计学意义（<0.05）。两组患者总手术时间、住院时间及死亡率差异无统计学意义（>0.05）。
对于严重多发骨折患者，应用损伤控制骨科可显著降低术后并发症、ICU恢复时间及术中输血量，为这类患者的临床治疗提供一定依据。
