摘要
目的探讨损伤控制和限制性体液复苏在严重下肢多发伤合并休克救治中的应用价值。方法下肢多发伤开放性骨折合并休克失代偿期(血压<90/60mmhg)75例,分为损伤控制组(31例)和对照组(44例),对损伤控制组的病例行骨折I期外固定,对照组病例II期行骨折固定,比较两组住院天数。75例又随机分为限制性体液复苏组(43例)和积极正压复苏组(32例),按各自原则进行补液,对相关变量进行统计学分析。结果74例存活,1例死亡。损伤控制组平均住院时间(18.1±6.3)天;对照组的平均住院时间(45.1±21.3)天,P<0.05。限制性体液复苏组病人术中、术后顺利,但其术前输液量与输液时间小于积极正压复苏组(P<0.05)。结论在严重下肢多发伤合并休克的救治中,应用损伤控制有积极意义,限制性体液复苏可能有益。
Objective To evaluate the value of damage control and limited fluid resuscitation for multiple injuries of lower extremity complicated with shock. Methods Seventy-five adult cases of multiple lower extremity fractures complicated with shock （BP≤〈90/60mmHg） were classified into two groups： the damage control group （31 cases） and the control group（44 cases）. The fractures of the damage group were emergently fixed by external fixation, and those of the control group were fixed lately. The hospitalization period of the two groups was compared. The 75 cases were classified into the limited fluid resuscitation group （43 cases ） and the active fluid resuscitation group（ 32 cases ）. The fluid resuscitation of the two groups was carried out by their respective principles. The relative variables were analyzed statistically. Results Seventy-four cases survived while one case died. The hospitalization period of the damage control group and the control group was （ 18.1 ± 6.3 ） days and （ 45.1 ± 21.3 ） days respectively（ P 〈0.05 ）. The cases of the limited fluid resuscitation group were uneventful during and after the surgery, but the preoperational transfusion quantities and time were significantly less than those of the active fluid resuscitation group（ P 〈 0.05 ）. Conclusion For the multiple injuries of lower extremity complicated with shock,damage control theory produces positive effects,while limited fluid resuscitation may be beneficial.
出处
《创伤外科杂志》
2007年第6期527-529,共3页
Journal of Traumatic Surgery
关键词
下肢
多发伤
损伤控制
体液复苏
休克
lower limbs
multi-injuries
damage control
fluid resuscitation
shock
