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(chuàng)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(jīng)過損傷控制性手術救治的嚴重損傷復蘇過程較平穩(wěn),腹部并發(fā)癥得到有效控制。痊愈6 例,死亡2例。術后出現(xiàn)膈下感染1例,膽瘺1例,經(jīng)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(jù)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(yī)學, 2009, 24(7): 1832-1834. doi: 復制
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- 4. PATRICK J, OFFNER, ALMERINDO LAURENCE DE SOUZA, et al. Avoidance of abdominal compartmentsyndrome in damage control laparotomy after trauma [J]. Arch Surg,2001,136:676681..
- 5. BAKE D E, KAUFMAN H J, SMITH L A, et al. Vacuum packtechnique of temporary abdominal Closure: a 7year 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..