Damage control surgery for patients with severe chest trauma complicated with limb and pelvic fractures
JIANG Luquan1, YANG Le2, ZHENG Jian1, CHEN Jian1
1. Department of Thoracic Surgery 2. Department of Orthopeadics, Jiangsu Provincial Corps Hospital of Chinese; People's Armed Police Force, Yangzhou 225003,China
Abstract：Objective To explore the applicability of damage control surgery for patients with severe chest trauma complicated with limb and pelvic fractures. Methods The clinical data on 98 patients with severe chest trauma complicated with limb fractures and pelvic fractures treated in our hospital between August 2014 and August 2019 was analyzed retrospectively. These patients were divided into the control group (46 cases) and the DCS treatment group (52 cases). Routine deterministic surgery was performed in the control group, while damage control surgery was performed in the DCS treatment group according to the injury control process within 10-14 days. After treatment, the duration of surgery, intraoperative bleeding volume, intraoperative blood transfusion volume, length of hospital stay, time spent in the ICU, days of mechanical ventilation, and rates of mortality and complications were compared between the two groups. Results The average length of hospital stay of the control group and the DCS treatment group was 26.91 d and 27.21 d respectively, compared with 13.12 d and 12.68 d in the ICU. There was no significant difference between the two groups. The duration of surgery of the two groups was (178.83±28.50 )min and (89.55±21.07 )min respectively, the days of mechanical ventilation were 7.12 d and 5.62 d respectively, the surgical bleeding volume was (692.68±42.59)ml and (268.52±39.67)ml respectively, and the intraoperative blood transfusion volume was(1024.20±30.10)ml and (610.85±40.24)ml respectively. There was statistically significant difference between the two groups (P<0.05).The complication rates of the control group and the DCS treatment group were 34.8% and 17.3% respectively, and the mortality rates were 23.9% and 7.7% respectively. There was significant difference between the two groups (P<0.05). Conclusions For patients with severe chest trauma combined with limb fractures and pelvic fractures, the use of damage control surgery can improve the survival rate of patients, which has good clinical value.
江吕泉, 杨乐, 郑建, 陈建. 损伤控制在严重胸部创伤合并四肢和骨盆骨折救治中的应用价值[J]. 武警医学, 2020, 31(5): 422-425.
JIANG Luquan, YANG Le, ZHENG Jian, CHEN Jian. Damage control surgery for patients with severe chest trauma complicated with limb and pelvic fractures. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(5): 422-425.
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