損傷控制外科技術在急診外科多發傷救治中的應用效果

邢海生 何羽強

[摘要] 目的 探討分析損傷控制外科技術在急診外科多發傷救治中的應用效果。方法 選取該院急診外科于2017年10月—2018年10月收治的多發傷患者80例作為研究對象，以隨機對照分組的方法將其分成兩組：對觀察組（40例）患者采用損傷控制外科技術進行救治，對對照組（40例）患者采用傳統方法進行救治，觀察比較兩組患者的：①出血量、體溫恢復時間、乳酸恢復時間及PT、APTT恢復時間;②搶救成功率;③并發癥發生率。 結果 ①觀察組患者的出血量、體溫恢復時間、乳酸恢復時間及PT、APTT恢復時間分別為（2 052.4±17.4）mL、（8.1±1.3）h、（11.3±5.8）h、（12.7±5.2）h，對照組患者的出血量、體溫恢復時間、乳酸恢復時間及PT、APTT恢復時間分別為（2 548.4±251.8）mL、（19.7±1.6）h、（33.6±7.7）h、（30.4±9.1）h，觀察組患者的出血量、體溫恢復時間、乳酸恢復時間及PT、APTT恢復時間均顯著短于對照組患者（t=11.982、14.125、21.731、11.518，P<0.05）。②觀察組患者的搶救成功率為92.5%，對照組患者的搶救成功率為67.5%，觀察組患者的搶救成功率顯著高于對照組患者（χ2=4.923，P<0.05）。③觀察組患者的DIC發生率、休克發生率及MODS發生率分別為7.5%、12.5%、2.5%，對照組患者的DIC發生率、休克發生率及MODS發生率分別為25.0%、42.5%、17.5%，觀察組患者的DIC發生率、休克發生率及MODS發生率均顯著低于對照組患者（χ2=4.272、5.618、3.996，P<0.05）。結論 在急診外科多發傷救治中采用損傷控制外科技術，可以有效減少患者的出血量，縮短體溫恢復時間、乳酸恢復時間及PT、APTT恢復時間，提高搶救成功率，降低并發癥發生率，值得臨床廣泛應用。

[關鍵詞] 損傷控制外科技術;急診外科;多發傷

[中圖分類號] R641? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）06（a）-0095-03

[Abstract] Objective To analyze the effect of injury control surgery in emergency surgery for multiple injuries. Methods A total of 80 patients with multiple injuries admitted to emergency surgery department of our hospital from October 2017 to October 2018 were divided into two groups： the observation group （40 cases） was convenient treated with damage control surgery technology， and the control group （40 cases） was treated with traditional methods. The amount of bleeding， the time of temperature recovery， the time of lactate recovery， the time of lactate recovery， the recovery time of PT and APTT， the success rate of rescue， and the incidence of complications were observed and compared between the two groups. Results 1. The bleeding volume， body temperature recovery time， lactic acid recovery time， and PT and APTT recovery time of the observation group were （2052.4±17.4） mL， （8.1±1.3） h， （11.3±5.8） h， （12.7±5.2） h， the bleeding volume， body temperature recovery time， lactic acid recovery time and PT， APTT recovery time of the control group were （2548.4±251.8） mL， （19.7±1.6） h， （33.6±7.7） h， （30.4±9.1 h， the bleeding volume， body temperature recovery time， lactic acid recovery time and PT， APTT recovery time were significantly shorter in the observation group than in the control group （t=11.982，14.125，21.731，11.518， P<0.05）. 2. The rescue success rate of the observation group was 92.5%， and the rescue success rate of the control group was 67.5%. The success rate of the observation group was significantly higher than that of the control group （χ2=4.923， P<0.05）.3. The incidence of DIC， the incidence of shock and the incidence of MODS in the observation group were 7.5%， 12.5%， 2.5%， respectively. The incidence of DIC， the incidence of shock and the incidence of MODS in the control group were 25.0% and 42.5%， respectively. 17.5%， the incidence of DIC， the incidence of shock and the incidence of MODS in the observation group were significantly lower than those in the control group （χ2=4.272，5.618，3.996， P<0.05）. Conclusion Damage control surgery can effectively reduce the amount of bleeding， shorten the recovery time of body temperature， lactic acid and PT， APTT， improve the success rate of rescue and reduce the incidence of complications in emergency surgery， which is worthy of clinical application.