损伤控制外科技术在急诊外科多发伤救治中的应用效果

邢海生 何羽强

[摘要] 目的 探討分析损伤控制外科技术在急诊外科多发伤救治中的应用效果。方法 选取该院急诊外科于2017年10月—2018年10月收治的多发伤患者80例作为研究对象，以随机对照分组的方法将其分成两组：对观察组（40例）患者采用损伤控制外科技术进行救治，对对照组（40例）患者采用传统方法进行救治，观察比较两组患者的：①出血量、体温恢复时间、乳酸恢复时间及PT、APTT恢复时间;②抢救成功率;③并发症发生率。 结果 ①观察组患者的出血量、体温恢复时间、乳酸恢复时间及PT、APTT恢复时间分别为（2 052.4±17.4）mL、（8.1±1.3）h、（11.3±5.8）h、（12.7±5.2）h，对照组患者的出血量、体温恢复时间、乳酸恢复时间及PT、APTT恢复时间分别为（2 548.4±251.8）mL、（19.7±1.6）h、（33.6±7.7）h、（30.4±9.1）h，观察组患者的出血量、体温恢复时间、乳酸恢复时间及PT、APTT恢复时间均显著短于对照组患者（t=11.982、14.125、21.731、11.518，P<0.05）。②观察组患者的抢救成功率为92.5%，对照组患者的抢救成功率为67.5%，观察组患者的抢救成功率显著高于对照组患者（χ2=4.923，P<0.05）。③观察组患者的DIC发生率、休克发生率及MODS发生率分别为7.5%、12.5%、2.5%，对照组患者的DIC发生率、休克发生率及MODS发生率分别为25.0%、42.5%、17.5%，观察组患者的DIC发生率、休克发生率及MODS发生率均显著低于对照组患者（χ2=4.272、5.618、3.996，P<0.05）。结论 在急诊外科多发伤救治中采用损伤控制外科技术，可以有效减少患者的出血量，缩短体温恢复时间、乳酸恢复时间及PT、APTT恢复时间，提高抢救成功率，降低并发症发生率，值得临床广泛应用。

[关键词] 损伤控制外科技术;急诊外科;多发伤

[中图分类号] R641          [文献标识码] A          [文章编号] 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.