Departments of Obstetrics & Gynecology and Anesthesiology, the University of Texas Medical Branch, Galveston, Texas; and the Division of Obstetrical Anesthesiology, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
Obstet Gynecol. 2018 Aug;132(2):423-427. doi: 10.1097/AOG.0000000000002743.
Damage-control surgery (abdominopelvic packing followed by a period of medical stabilization in the intensive care unit) is a life-saving intervention usually reserved for critically injured patients who may not survive an attempt to achieve hemostasis and complete repair of the damage in the operating room. Most obstetricians have little or no experience in this area, although the use of damage-control surgery in selected cases may be life-saving. This approach should be considered when arterial bleeding has been controlled and persistent bleeding is deemed to be secondary to coagulopathy that is refractory to blood product replacement, particularly in the presence of hypothermia, acidosis, and vasopressor requirement. A prototypical (albeit hypothetical) case is described here in which damage-control surgery is indicated.
损伤控制性手术（剖腹盆腔填塞，随后在重症监护病房进行一段时间的医疗稳定）是一种救命干预措施，通常保留给可能无法在手术室实现止血和完全修复损伤的危重患者。大多数妇产科医生在这方面经验很少或没有，尽管在某些情况下使用损伤控制性手术可能是救命的。当动脉出血得到控制且持续出血被认为继发于对血液制品替代无效的凝血功能障碍时，特别是在存在低体温、酸中毒和血管加压素需求的情况下，应考虑采用这种方法。这里描述了一个典型（尽管是假设的）病例，其中需要进行损伤控制性手术。
