摘要
目的观察采用损伤控制性手术对重症肝胆外伤患者治疗效果及死亡率的影响。方法将南阳市第一人民医院2019年1月—2020年6月期间收治的重症肝胆外伤患者118例采用随机数字表法随机分为观察组(n=61例)和对照组(n=57例),对照组按照常规方法完成急诊手术,观察组则按照损伤控制性手术方法进行手术,比较两组患者的手术指标(术中出血量、手术时间、住院天数)和结局指标(并发症发生率、感染率、死亡率、术后恢复时间)。结果观察组术中出血量、手术时间、住院天数分别为(312.54±42.37)mL、(63.38±7.29)min、(17.28±5.33)d,均明显低于对照组的(631.28±67.85)mL、(93.65±10.27)min、(21.14±7.09)d,两组比较差异均有统计学意义(t=8.998、7.962、6.137,均P<0.05)。观察组的并发症发生率、感染率、死亡率、术后恢复时间分别为9.80%(5/51)、9.80%(5/51)、16.39%(10/61)、(15.36±5.20)d,均低于对照组的35.14%(13/37)、32.43(12/37)、35.09%(20/57)、(19.17±6.13)d,两组比较差异均有统计学意义(t值/χ2值=9.135、9.011、7.986、7.254,均P<0.05)。结论应用损伤控制性手术治疗重症肝胆外伤患者可提高手术效果,减少死亡率,促进患者早日康复。
Objective To observe the effect of damage control surgery on the treatment and mortality of patients with severe hepatobiliary trauma.Methods Totally 118 patients with severe hepatobiliary trauma in our hospital from January 2019 to June 2020 were randomly divided into observation group(n=61 cases) and control group(n=57 cases) by random number table method. The control group completed emergency operation according to conventional method, while the observation group was operated according to damage control operation method. The operation indexes(intraoperative blood loss, operation time, hospital stay) of the two groups were compared The incidence of complications, infection rate, mortality and postoperative recovery time were compared.Results The intraoperative blood loss, operation time and hospitalization days in the observation group were(312.54±42.37)mL,(63.38±7.29)min and(17.28±5.33)d, which were significantly lower than those of(631.28±67.85)mL,(93.65±10.27)min and(21.14±7.09)d in the control group, and the differences between the two groups were statistically significant(t=8.998,7.962,6.137, all P<0.05).The incidence of complications, infection rate, mortality and postoperative recovery time of the observation group were 9.80%(5/51),9.80%(5/51),16.39%(10/61),(15.36±5.20)D, which were lower than 35.14%(13/37),32.43(12/37),35.09%(20/57),(19.17±6.13)d in the control group, and the differences were statistically significant(t value/χ2=9.135,9.011,7.986,7.254, all P<0.05).Conclusion The application of damage control surgery in the treatment of severe hepatobiliary trauma can improve the surgical effect, reduce the mortality rate and promote the early recovery of patients.
作者
刘建
李权
王松
何行昌
LIU Jian;LI Quan;WANG Song;HE Xing-chang(The First People's Hopsital of Nanyang CityNanyang,Henan 4130001 China)
出处
《医药论坛杂志》
2021年第3期16-19,共4页
Journal of Medical Forum
基金
2019年河南省医学科技攻关计划联合共建项目(LHGJ20191495)。
关键词
肝胆外伤
死亡率
并发症
重症监护室
车祸
胆囊
肝脏
损伤控制性手术
Hepatobiliary trauma
Mortality rate
Complication
ICU
Traffic accident
Gallbladder
liver
Injury control surgery
