微创医学

目的研究损伤控制性手术(damage control operation,DCO)在救治严重肝外伤中的临床价值。方法选取重度肝外伤患者60例,其中30例行控制性手术,设为A组;另外30例行传统规则性肝脏损伤手术,设为B组。观察两组病人术后ICU监测指标:pH值、体温、PT、APTT及术后ARDS、MODS、DIC发生率和死亡率。结果两组术后pH值、体温、PT、APTT差异有统计学意义(P<0.05)。术后并发症ARDS B组(6例)多于A组(1例);MODS B组(15例)多于A组(1例);DIC B组(15例)多于A组(1例);B组死亡(19例)多于A组(1例),差异均有统计学意义(P<0.05)。结论及时实施损伤控制性肝脏手术能有效救治重度肝外伤患者的生命,大大降低死亡率

Objective To study clinical value of idea of damage control operation ( DCO) in the treatment of severe hepatic trauma． Methods Sixty patients of severe hepatic trauma were enrolled into the study，of which，30 were performed with DCO as group A， and the other 30 with traditional regular liver injury operation as group B． ICU monitoring index of pH，temperature，PT，APTT and postoperative rate of AＲDS， MODS，DIC and mortality were observed of the two groups．Ｒesults There was clinical significant difference in pH，temperature，PT，and APTT after surgery between the two groups． As far as the postoperative complications were concerned，six AＲDS were recorded in group B，whereas only 1 in group A; 15 MODS in group B，whereas 1 in group A; 15 DIC in group B，whereas 1 in group A; and 19 death in group B，whereas 1 in group A，all with statistical significance( P ＜ 0． 05 ) ． Conclusion Timely implementation of DCO can effectively save the life of patients of severe hepatic trauma，thus greatly reduce mortality of severe hepatic trauma．

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