損傷控制性手術救治嚴重腹部損傷_《華西醫學》

作者：

何德海 , 甘啟祥 , 楊益森 , 張曉旭

四川省廣元市第二人民醫院,四川廣元 628017;

關鍵詞：

嚴重腹部外傷損傷控制性手術

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的:通過對嚴重腹部損傷患者實施損傷控制性手術策略和方法,提高創傷的搶救成功率。方法:回顧分析8 例嚴重腹部損傷 (ISS gt;16)患者應用損傷控制性手術的策略進行救治的情況,8例患者入院后在積極抗休克急救處理的同時進行急診剖腹探查手術,初期均采用大紗墊填塞的方法控制出血后關腹,ICU 內復蘇后,所有患者都進行了Ⅱ期計劃性手術。結果:經過損傷控制性手術救治的嚴重損傷復蘇過程較平穩,腹部并發癥得到有效控制。痊愈6 例,死亡2例。術后出現膈下感染1例,膽瘺1例,經引流治療痊愈。結論:對于符合DCO 指征的嚴重腹部損傷的患者要盡早、盡快地實施DCO,提高綜合治療水平,根據腹部損傷的部位和程度,采取適宜的再次確定手術的方式,可以有效地降低嚴重腹部損傷病死率。

引用本文： 何德海,甘啟祥,楊益森,張曉旭. 損傷控制性手術救治嚴重腹部損傷. 華西醫學, 2009, 24(7): 1832-1834. doi: 復制

1.	STON H H, STROM P R, MULLINS R J. Management of the major coagulopathy with onset during laparotomy[J]. Ann Surg,1983,197:532-535..
2.	KOURAKLIS G, SPRAKOS S, GLINAVOU A. Damage control surgery. An alterma2tive approach for the management of critically injured patients[J]. Surg Today,2002,32(3):195-202..
3.	BRASEL K J, KU J, BAKER C C, et al. Damage control in thecritically ill and injured patient[J]. New Horiz,1999,7:73-86..
4.	PATRICK J, OFFNER, ALMERINDO LAURENCE DE SOUZA, et al. Avoidance of abdominal compartmentsyndrome in damage control laparotomy after trauma [J]. Arch Surg,2001,136:676681..
5.	BAKE D E, KAUFMAN H J, SMITH L A, et al. Vacuum packtechnique of temporary abdominal Closure: a 7year experiencewith 112 patients[J]. J Trauma,2000,48:201-206..
6.	SAGGI B H, SURERMAN H J, IVATURY R R, et al. Abdominalcompartment syndrome[J]. J Trauma, 1998, 45: 597- 609..
7.	WALKER, CRIDDLE. Pathophysiology and management of abdominal compartment syndrome[J]. Am J Crit Care, 2003,12:367-371..

1. STON H H, STROM P R, MULLINS R J. Management of the major coagulopathy with onset during laparotomy[J]. Ann Surg,1983,197:532-535..
2. KOURAKLIS G, SPRAKOS S, GLINAVOU A. Damage control surgery. An alterma2tive approach for the management of critically injured patients[J]. Surg Today,2002,32(3):195-202..
3. BRASEL K J, KU J, BAKER C C, et al. Damage control in thecritically ill and injured patient[J]. New Horiz,1999,7:73-86..
4. PATRICK J, OFFNER, ALMERINDO LAURENCE DE SOUZA, et al. Avoidance of abdominal compartmentsyndrome in damage control laparotomy after trauma [J]. Arch Surg,2001,136:676681..
5. BAKE D E, KAUFMAN H J, SMITH L A, et al. Vacuum packtechnique of temporary abdominal Closure: a 7year experiencewith 112 patients[J]. J Trauma,2000,48:201-206..
6. SAGGI B H, SURERMAN H J, IVATURY R R, et al. Abdominalcompartment syndrome[J]. J Trauma, 1998, 45: 597- 609..
7. WALKER, CRIDDLE. Pathophysiology and management of abdominal compartment syndrome[J]. Am J Crit Care, 2003,12:367-371..

《華西醫學》

損傷控制性手術救治嚴重腹部損傷

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《華西醫學》

損傷控制性手術救治嚴重腹部損傷

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料