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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

34

期数:

2017年8

页码:

748-750

栏目:

临床研究

出版日期:

2017-08-05

文章信息/Info

Title:

Application of damage control surgical technique in the treatment of severe abdominal trauma and acute abdomen

作者:

李小冬; 桂得春

（南京市浦口区中心医院普外科，江苏　南京　211800）

Author(s):

LI Xiao-dong; GUI De-chun

（Department of General Surgery，Pukou District Central Hospital of Nanjing，Nanjing 211800，Jiangsu Province，China）

关键词:

损伤控制性外科技术; 腹部严重创伤; 急腹症

Keywords:

control surgical technique; severe abdominal trauma; acute abdomen

分类号:

R656.1

DOI:

10.7683/xxyxyxb.2017.08.023

文献标志码:

A

摘要:

目的　探讨损伤控制性外科技术在腹部严重创伤及急腹症救治中的应用价值。方法　选取2012年10月至2015年10月南京市浦口区中心医院普外科收治的60例接受损伤控制性外科技术的腹部严重创伤及急腹症患者为观察组，并选择同时期60例接受常规外科急救处理的腹部严重创伤及急腹症患者为对照组，比较2组患者急性生理和慢性健康评估Ⅱ（APACHEⅡ）评分［年龄评分（YS）、急性生理学评分（APS）、慢性疾病评分（CPS）］、药物使用量、进食时间、术后排气时间、引流管留置时间、住院时间和并发症发生率。结果　2组患者术前APACHEⅡ总分、APS、YS和CPS比较差异无统计学意义（P>0.05）。术后2组患者APACHEⅡ总分及APS均较术前显著下降（P<0.05），YS和CPS与术前比较差异无统计学意义（P>0.05）。观察组患者术后APACHEⅡ总分及APS均较对照组显著下降（P<0.05），YS和CPS与对照组比较差异无统计学意义（P>0.05）。观察组患者浓缩红细胞悬液、血浆及羟乙基淀粉使用量显著少于对照组（P<0.05），进食时间、术后排气时间、引流管留置时间及住院时间均短于对照组（P<0.05），术后感染、吻合口瘘等并发症发生率显著低于对照组（χ²=4.675,P<0.05）。结论　采取损伤控制性外科技术处理腹部严重创伤及急腹症患者具有积极意义。

Abstract:

Objective　To analysis the value of the application of damage control surgical technique in the treatment of severe abdominal trauma and acute abdomen.Methods　Sixty patients with severe trauma or acute abdomen who underwent damage control surgical technique from October 2012 to October 2015 in Department of General Surgery of Pukou District Central Hospital of Nanjing were selected as observation group，at the same time，60 patients with severe abdominal trauma or acute abdomen who were treated by routine surgical treatment were taken as control group.The acute physiology and chronic health evaluationⅡ（APACHEⅡ） scores，year score（YS），acute physiology score （APS），chronic pathema score(CPS),drug usage amount，feeding time，postoperative exhaust time，drainage tube indwelling time，hospitalization time and complication rate were compared between the two groups.Results　There was no significant difference in APACHE Ⅱ scores，APS，YS and CPS between the two groups before treatment（P>0.05）.The APACHE Ⅱ score and APS of the two groups after operation were significantly lower than those of the preoperative group （P<0.05），while there was no significant difference in YS and CPS（P>0.05）.The APACHE Ⅱ score and the APS of the observation group were lower than those of control group（P<0.05），while there was no significant difference in YS and CPS（P>0.05）.The usage of concentrated red cell blood，plasma and hydroxyethyl starch of the observation group were significantly lower than those of control group（P<0.05）；the time of feeding after operation，the time of exhausting after operation，the length of drainage tube stay and the length of stay in the observation group were significantly shorter than those in the control group（P<0.05）；the incidence of complications such as postoperative infection，anastomotic fistula in the observation group was significantly lower than that in the control group （χ²=4.675，P<0.05）.Conclusion　The application of damage control surgical technique in the treatment of severe abdominal trauma and acute abdomen has a positive significance.

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更新日期/Last Update: 2017-08-05