损伤控制在地震致脊柱骨折复合伤救治中的体会(附14例报告)
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摘要
目的:探讨损伤控制技术在地震致脊柱骨折复合伤患者救治中的临床效果。方法:回顾性分析14例"5.12"汶川大地震致脊柱骨折复合伤患者的临床资料,所有患者按损伤控制理论分三阶段治疗,经早期处理,进一步复苏后再行确定性手术,随访患者治疗结果,评估其临床疗效。结果:所有患者按损伤控制治疗效果满意,无死亡病列发生。12例获得随访,平均随访24月,脊柱矫形满意,无内固定松动、断裂等并发症,5例伴神经损伤者除1例截瘫外,神经功能按Frankel分级都有1~2级的恢复。结论:地震致脊柱骨折复合伤是严重的创伤,及时应用损伤控制技术可以提高患者救治成功率,降低伤残率。
Objective: To explore the clinical results of damage control in patients with combined injury and spinal fracture from earthquake.Methods:The clinical data in 14 patients with combined injury and spinal fracture from "5.12 Wenchuan Earthquake"was analysed retrospectively.According to damage control theory all the patients were treated with three stages: first-aid,continued resuscitation and definitive surgery.The patients were followed up and the clinical effect was assessed.Results: The patients were cured with satisfactory results without death case.12 patients were followed up for average 24 months.Spine corrective operation succeeded without looseness or breakage of interfixation and other conlplications.5 patients with spinal cord injury,except one with paraplegia,were improved 1~2 grade according to Frankel grading system.Conclusion: The application of damage control can increase the therapy achievement rate and decrease the disabled rate in patients with combined injury and spinal fracture from earthquake.
Objective: To explore the clinical results of damage control in patients with combined injury and spinal fracture from earthquake.Methods:The clinical data in 14 patients with combined injury and spinal fracture from "5.12 Wenchuan Earthquake"was analysed retrospectively.According to damage control theory all the patients were treated with three stages: first-aid,continued resuscitation and definitive surgery.The patients were followed up and the clinical effect was assessed.Results: The patients were cured with satisfactory results without death case.12 patients were followed up for average 24 months.Spine corrective operation succeeded without looseness or breakage of interfixation and other conlplications.5 patients with spinal cord injury,except one with paraplegia,were improved 1~2 grade according to Frankel grading system.Conclusion: The application of damage control can increase the therapy achievement rate and decrease the disabled rate in patients with combined injury and spinal fracture from earthquake.
引文
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7.Nicholas B,Toth L,van Wessem K,et al.Borderlinefemur fracture patients:early total care or damage controlorthopaedics[J].ANZ J Surg,2011;81(3):148
2.Heyde CE,Ertel W,Kayser R.Management of spine injuriesin polytraumatized patients[J].Orthopade,2005;34(9):889
3.Liu SH,Wang AM,Du QY,Damage control of multipleinjuries headed by cervical spinal cord injury[J].Chin J,Traumatol,2008;11(1):45
4.Yang J,Gao JM,Hu P,et al.Application of damage con-trol orthopedics in 41 patients with severe multiple injuries[J].Chin J Traumatol,2008;11(3):157
5.蔡晓辉,程飙.损伤控制骨科在临床骨科损伤患者72例中的应用[J].四川医学,2010;31(5):643
6.杨友刚,蒋电明,倪卫东.损伤控制骨科理论在地震致骨盆骨折救治中的应用[J].临床合理用药杂志,2009;2(5):30
7.Nicholas B,Toth L,van Wessem K,et al.Borderlinefemur fracture patients:early total care or damage controlorthopaedics[J].ANZ J Surg,2011;81(3):148
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