损伤控制外科理论在重型颅脑损伤伴多发伤患者救治中的应用
Application of Damage Control Surgery in Severe Traumatic Brain Injury Combined with Multiple Injuries

作者: 王向东 , 任新亮 , 王彦宏 , 陈芳 , 李建红 , 赵志强 :长治医学院附属和济医院神经外科,山西,长治;

关键词: 损伤控制外科重型颅脑损伤多发伤Damage Control Surgery Severe Traumatic Brain Injury Multiple Injuries

摘要:

目的:探讨损伤控制外科(DCS)理念在重型颅脑损伤伴多发伤患者救治中的应用。方法:回顾性分析采用DCS理念救治的69例重型颅脑损伤伴多发伤患者的临床资料,总结应用DCS理念救治重型颅脑损伤伴多发伤患者的临床效果。结果:本组69例患者,随访6个月,按格拉斯哥结局量表(GOS)分级:恢复良好31例;中度残疾8例;重度残疾19例;植物状态5例;死亡6例。结论:应用DCS理念针对重型颅脑损伤伴多发伤患者及时给予救治,明显提高救治成功率,降低死亡率。

Abstract: Objective: To discuss the application of damage control surgery (DCS) in the treatment of severe traumatic brain injury combined with multiple injuries. Methods: The clinical data of 69 severe traumatic brain injury combined with multiple injuries patients who were treated with DCS were reviewed retrospectively. The concept and complications of DCS in treatment of severe traumatic brain injury combined with multiple injuries patients are summarized. Results: There are 69 patients, who’ve been followed up for 6 months. According to Glasgow outcome score method, 31 cases recovered well, 8 cases were moderate disability, 19 cases were severe disability, 4 cases were in vegetative state, and 6 cases died. Conclusions: Application of damage control surgery in severe traumatic brain injury combined with multiple injuries can improve the rescue efficiency and decrease the mortality.

文章引用: 王向东 , 任新亮 , 王彦宏 , 陈芳 , 李建红 , 赵志强 (2015) 损伤控制外科理论在重型颅脑损伤伴多发伤患者救治中的应用。 亚洲急诊医学病例研究, 3, 1-5. doi: 10.12677/ACREM.2015.31001

参考文献

[1] 王正国 (2004) 多发伤的救治. 中华创伤杂志, 1, 1-3.

[2] Diaz, J.J., Cullinane, D.C., Dutton, W.D., et a1. (2010) The management of the open abdomen in trauma and emergency general surgery: Part l—Damage control. Journal of Trauma and Acute Care Surgery, 68, 1425-1438.

[3] 冯华, 李飞, 朱刚, 等 (2010) 重视损伤控制理论在重型颅脑损伤患者救治中的应用. 中华创伤杂志, 10, 865-867.

[4] 秦怀海, 张楠, 任印斌 (2010) 煤矿重型颅脑损伤合并多发伤的救治. 中华急诊医学杂志, 4, 425-426.

[5] 张小兵, 任洪清 (2013) 以颅脑损伤为主严重多发伤的整体救治. 中国伤残医学, 12, 85-86.

[6] 张连阳 (2007) 努力提高多发伤救治速度. 中华创伤杂志, 4, 241-243.

[7] 孙志扬, 刘中民, 刘建军, 等 (2005) 重型颅脑外伤合并多发伤的救治. 中华急诊医学杂志, 2, 112-113.

[8] 吴广宇, 徐洪波, 赵峰, 等 (2005) 132例颅脑损伤合并多发伤的救治分析. 中华创伤杂志, 12, 946-947.

[9] 黄国兵, 潘学武, 曹盛生, 等 (2013) 颅脑损伤合并多发伤的预后影响因素分析及急诊救治探讨. 中华神经医学杂志, 8, 819-822.

[10] Sawauchi, S., Beaumont, A., Signorettis, S., et al. (2002) Diffuse brain injury complicated by acute subdural hematoma and secondary insults in the rodents: The effect of surgical evacuation. Acta Neurochirurgica Supplements, 8l, 24l-242.

[11] 任新亮, 李帆, 王向东, 等 (2013) 损伤控制外科理念在外伤性颅内静脉窦破裂治疗中的应用. 中华创伤杂志, 11, 1057-1058.

[12] 王宁, 白祥军, 郑国寿, 等 (2011) 不同急救模式对合并颅脑损伤的多发伤患者预后的影响. 中华创伤杂志, 1, 16-18.

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