下肢毁损伤分段损伤控制救治研究

Research on staged injury control and treatment of severe lower limb damages

摘要:

［目的］探讨分段损伤控制在下肢毁损伤患者临床急救中的应用价值。［方法］116 例下肢毁损伤患者根据急救方法的不同分为两组：研究组 （64 例） 根据损伤控制理论实施分段治疗，对照组 （52 例） 实施常规急救治疗。对比两组的抢救及下肢功能恢复情况。［结果］ 研究组的抢救成功率高于对照组，急救时间、ICU 天数、平均住院时间均短于对照组 （P<0.05）。 急救后 1 个月，研究组患者的肌力、屈伸度值均显著高于对照组，膝关节僵硬、局部肿胀、局部水泡发生率均显著低于对照组 （P<0.05）。研究组的并发症总发生率显著低于对照组，家属总满意率显著高于对照组（P<0.05）。［结论］分段损伤控制用于下肢毁损伤救治可有效缩短急救时间，提高急救成功率，促进下肢功能恢复。

Abstract:

[Objective] To explore the significance of staged injury control and treatment for severe lower extremity damages in emer- gency. [Methods] A total of 116 patients with severe lower extremity injuries were divided into two groups according to treatment in emer- gency. Of them, 64 patients in the trial group received staged injury control and surgical treatment according to the theory of damage con- trol, while the remaining 52 patients in the control group underwent conventional emergent treatment. The rescue and lower limb function recovery were compared between the two groups. [Results] The trial group proved significantly higher rescue success rate, whereas signifi- cantly shorter emergency time, ICU days, and hospital stay than the control group (P＜0.05) . At one month after emergent surgical treat- ment, the trial group had significantly higher muscle strength and flexion and extension range of motion (ROM) , whereas significantly lower incidence of knee stiffness, local swelling, local blisters and complication in total than the control group (P＜0.05) . The trial group was marked significantly higher total satisfaction rate of family members than the control group (P＜0.05) . [Conclusion] The use of staged injury control and surgical treatments for severe lower extremity injuries does effectively shorten the time elapsed in emergency, increase the suc- cess rate of rescue, and promote the recovery of lower extremity functions.