本文關(guān)鍵詞：損傷控制外科理論在腹部外科擇期手術(shù)中的應(yīng)用，由筆耕文化傳播整理發(fā)布。

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damage control operation

     Damage control operation for severe pancreatic trauma: a retrospective analysis of 19 cases

     損傷控制剖腹術(shù)治療嚴(yán)重胰腺損傷19例

短句來源

     Objective To explore the current management strategy and effect of damage control operation(DCO)for severe pancreatic trauma.

     目的總結(jié)損傷控制剖腹術(shù)(dam age control laparotomy,DCL)治療嚴(yán)重胰腺損傷的經(jīng)驗(yàn)。

短句來源

     Application of damage control operation on serious abdominal trauma

     損傷控制性手術(shù)在嚴(yán)重腹部損傷的應(yīng)用

短句來源

     All the patients received early operation,in which 43 cases underwent the definitive operation,33 cases received damage control operation because of too severe injury.

     所有患者均接受了早期急診手術(shù),其中43例早期行確定性手術(shù),33例因傷情特別危重而行損害控制手術(shù)。

短句來源

     Objective To explore the effects of damage control operation (DCO) of combined pancreatoduodenal injuries with serious trauma.

     目的探討損傷控制手術(shù)在嚴(yán)重多發(fā)傷合并胰十二指腸損傷中的應(yīng)用。

短句來源

     Damage control surgery in selective abdominal operation

     損傷控制外科理論在腹部外科擇期手術(shù)中的應(yīng)用

短句來源

     Control technology and operation.

     控制工藝技術(shù)條件及操作。

短句來源

     Damage Control Orthopedics

     傷害控制骨科

     Damage control surgery

     損害控制外科

短句來源

     Application of damage control operation on serious abdominal trauma

     損傷控制性手術(shù)在嚴(yán)重腹部損傷的應(yīng)用

短句來源

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  damage control operation

Rumsfeld, the Bush administration initiated a damage control operation by passing a law that regulates the Military Commissions.

Objective To explore the current management strategy and effect of damage control operation(DCO)for severe pancreatic trauma. Methods The clinical data of 19 cases with severe pancreatic trauma were selected as the object of this study.A retrospective analysis was done on preference of DCO moduses and perioperative therapies.Results Operations were performed in all 19 patients including six cases(32%) treated with rapid surgical haemorrhage control,wound excision and drainage,three(11%) with...

Objective To explore the current management strategy and effect of damage control operation(DCO)for severe pancreatic trauma. Methods The clinical data of 19 cases with severe pancreatic trauma were selected as the object of this study.A retrospective analysis was done on preference of DCO moduses and perioperative therapies.Results Operations were performed in all 19 patients including six cases(32%) treated with rapid surgical haemorrhage control,wound excision and drainage,three(11%) with Cogbill operation and 10(53%) with Whipple operation without reconstituted digestive tract.Then,all cases were under reoperations after SICU resuscitation.Death was caused by associated organs injuries and secondary infection,with mortality rate of 11%.The pancreatic fistula occurred in two cases(11%) that were healed by conservative treatments.Conclusion For severe pancreatic trauma cases in accordance with DCO indications,active and reasonable operation should be done according to location and degree of pancreas injury.

目的總結(jié)損傷控制剖腹術(shù)(dam age control laparotomy,DCL)治療嚴(yán)重胰腺損傷的經(jīng)驗(yàn)。方法回顧性分析采用DCL治療的19例嚴(yán)重胰腺損傷患者的手術(shù)方式選擇和后續(xù)治療情況。結(jié)果6例行快速止血、清創(chuàng)及引流(32%),3例行改良Cogb ill手術(shù)(16%),10例行消化道未重建的胰十二指腸切除(53%)。SICU復(fù)蘇后,所有患者均接受再次確定性手術(shù)。死亡2例(11%),死亡原因與手術(shù)無關(guān);治愈17例(89%),術(shù)后出現(xiàn)胰瘺2例(11%),經(jīng)保守治療痊愈。結(jié)論符合DCL指征的嚴(yán)重胰腺損傷的患者,應(yīng)根據(jù)不同損傷胰腺部位和程度,積極選用適宜的方式,分次手術(shù)治療。

Objective To analyze the clinical characteristics and the outcome of severe trauma of various ages in emergency department,to improve the therapeutic effect of emergency rescuing.Methods Two thousand and sixty nine patients of severe trauma were treated during a seven-year period from October 1997 to October 2004.The studied patients were divided into 5 groups:(1)adolescent group(Group A,＜13 years old,n=106);(2)juvenile group(Group B, 13-18 years old,n=128);(3)youth group(Group C,18-40 years old,n=1518);(4)middle...

Objective To analyze the clinical characteristics and the outcome of severe trauma of various ages in emergency department,to improve the therapeutic effect of emergency rescuing.Methods Two thousand and sixty nine patients of severe trauma were treated during a seven-year period from October 1997 to October 2004.The studied patients were divided into 5 groups:(1)adolescent group(Group A,＜13 years old,n=106);(2)juvenile group(Group B, 13-18 years old,n=128);(3)youth group(Group C,18-40 years old,n=1518);(4)middle age group(Group D, 40-60 years old,n=215);and(5)elderly group(Group E,＞60 years old,n=102).All the patients were evaluated with Injury Severity Score(ISS),and the result was≥16 in all of the studied patients.Results The incidence of severe trauma in male in all 5 groups was higher than that in female,and it was significantly higher in Group C,Group D and Group E when compared with that in the other groups(P＜0.01).Traffic accident was the leading cause of injury,and its incidence in Group A,Group B and Group D was higher than that in other groups(P＜0.01).However,injury caused by falling from high places was the second cause of injury,being significantly increased in Group A,while armed fighting and injury during work being significantly increased in Group B,Group C and Group D,slip fall injury being significantly increased in Group E(P＜0.01).Head injury was mainly found in Group A and Group E,extremities injury and/or spinal injury were increased markedly in Group B,Group C and Group D(P＜0.05),abdominal injury was significantly decreased in Group E(P＜0.001).The total mortality was 11.9%(246/2069).The mortality within 24 hours (20.6%,21/102)was significantly higher than that beyond 24 hours(7.8%,8/102)in Group E(P＜0.01).The time of staying in the emergency department differed significantly between the survived patients and those died in all 5 groups (P＜0.01).Conclusion The gender,the incidence and the characteristics of the injury causes and injury sites differed between severely injured patients of various ages.Mortality in the elderly is significantly increased following severe trauma. The idea of“golden one hour”and“platinum ten minutes”,measures of shortening the time of staying in the emergency clinic,early definite operation and damage control operation should be emphasized.

目的分析不同年齡組嚴(yán)重創(chuàng)傷的臨床特征和救治結(jié)果,以提高嚴(yán)重創(chuàng)傷的急診救治水平。方法1997年10月至2004年10月7年間共救治嚴(yán)重創(chuàng)傷患者2069例,分為兒童組(＜13歲)106例,少年組(13～18歲)128例,青壯年組(18～40歲)1518例,中年組(40～60歲)215例,老年組(＞60歲) 102例。入選病例按損傷嚴(yán)重程度評分(ISS)標(biāo)準(zhǔn)進(jìn)行評估,所有患者ISSl≥16。結(jié)果各組男性患者均多于女性,青年組、中年組和老年組男性嚴(yán)重創(chuàng)傷比例顯著高于兒童組和少年組(P＜0．01)。交通傷是首要致傷原因,兒童組、少年組和中年組高于青壯年和老年組(P＜0．01)；第二位致傷原因墜落傷在兒童組,械斗與工傷在少年組、青壯年組和中年組,跌傷在老年組中顯著增高(P＜0．01)。兒童組和老年組以顱腦損傷為主；而少年組、青壯年組和中年組在四肢和(或)脊柱的損傷中顯著增高(P＜0．05)。老年組腹部損傷顯著減少(P＜0．01)。總病死率為11．9%(246/2 069),老年組創(chuàng)傷＜24 h病死率(20．6%,21/102)較≥24 h病死率(7．8%,8/102)顯著增高(P＜0．01)。各組的急診滯留時間,在搶救脫...

目的分析不同年齡組嚴(yán)重創(chuàng)傷的臨床特征和救治結(jié)果,以提高嚴(yán)重創(chuàng)傷的急診救治水平。方法1997年10月至2004年10月7年間共救治嚴(yán)重創(chuàng)傷患者2069例,分為兒童組(＜13歲)106例,少年組(13～18歲)128例,青壯年組(18～40歲)1518例,中年組(40～60歲)215例,老年組(＞60歲) 102例。入選病例按損傷嚴(yán)重程度評分(ISS)標(biāo)準(zhǔn)進(jìn)行評估,所有患者ISSl≥16。結(jié)果各組男性患者均多于女性,青年組、中年組和老年組男性嚴(yán)重創(chuàng)傷比例顯著高于兒童組和少年組(P＜0．01)。交通傷是首要致傷原因,兒童組、少年組和中年組高于青壯年和老年組(P＜0．01)；第二位致傷原因墜落傷在兒童組,械斗與工傷在少年組、青壯年組和中年組,跌傷在老年組中顯著增高(P＜0．01)。兒童組和老年組以顱腦損傷為主；而少年組、青壯年組和中年組在四肢和(或)脊柱的損傷中顯著增高(P＜0．05)。老年組腹部損傷顯著減少(P＜0．01)�？偛∷缆蕿�11．9%(246/2 069),老年組創(chuàng)傷＜24 h病死率(20．6%,21/102)較≥24 h病死率(7．8%,8/102)顯著增高(P＜0．01)。各組的急診滯留時間,在搶救脫險(xiǎn)病例和死亡病例之間比較,差異具有統(tǒng)計(jì)學(xué)意義(P＜0．01)。結(jié)論各年齡組嚴(yán)重創(chuàng)傷患者在性別構(gòu)成、致傷原因和致傷部位的發(fā)病率及其特點(diǎn)是不同的,老年患者在遭受嚴(yán)重創(chuàng)傷后死亡率明顯增高；觀念上要重視“黃金1小時”,“白金10分鐘”,縮短急診滯留時間；早期實(shí)施手術(shù)搶救；應(yīng)用損傷控制性手術(shù)。

Objective To explore re-operation of the patient with severe trauma in intensive care unit(ICU).Methods Seventy-six patients with severe trauma received re-operation in ICU from January 2000 to December 2006,among which 58 cases were multiple trauma(ISS>16 in 16 cases,ISS≥25 in 42 cases),18 cases were single trauma(AIS >3).All the patients received early operation,in which 43 cases underwent the definitive operation,33 cases received damage control operation because of too severe injury.During the intensive...

Objective To explore re-operation of the patient with severe trauma in intensive care unit(ICU).Methods Seventy-six patients with severe trauma received re-operation in ICU from January 2000 to December 2006,among which 58 cases were multiple trauma(ISS>16 in 16 cases,ISS≥25 in 42 cases),18 cases were single trauma(AIS >3).All the patients received early operation,in which 43 cases underwent the definitive operation,33 cases received damage control operation because of too severe injury.During the intensive care,40 patients who received routine operation,underwent re-operation because of stress ulcer;intestinal fistula,abscess of pleural cavity or intraperitoneal abscess,gangrene of gallbladder and hemorrhage.Results Fifty-nine patients were cured(77.6%),17 patients died.The main causes of early death were respiratory and circulatory failure because of severe injury,and the late death causes were multiple organ failure.Conclusion The patients with severe trauma should be observed intensively in intensive care unit,diagnosed and operated promptly to solve secondary pathological changes.The perfect diagnosis is needed.The definitive operation should be taken as soon as possible within 48 hours after injury.The staging operation should be taken in the patients with unstable vital signs.

目的探討嚴(yán)重創(chuàng)傷病人ICU治療期間的再手術(shù)治療。方法2000年1月~2006年12月對76例嚴(yán)重創(chuàng)傷病人在ICU治療期間行再次手術(shù)治療,其中58例為多發(fā)傷,ISS>16分16例,≥25分42例;18例為單發(fā)傷,AIS評分均>3分。所有患者均接受了早期急診手術(shù),其中43例早期行確定性手術(shù),33例因傷情特別危重而行損害控制手術(shù)。在ICU治療期間行損害控制手術(shù)的病人根據(jù)情況行確定性手術(shù),40例常規(guī)手術(shù)的病人發(fā)生應(yīng)激性潰瘍、腸瘺、胸腹腔膿腫、膽囊壞疽、出血等繼發(fā)性病變而行再次手術(shù)治療。結(jié)果59例救治成功,救治成功率達(dá)77.6%;17例死亡,早期死亡主要原因?yàn)樵l(fā)性損傷過重直接導(dǎo)致呼吸循環(huán)衰竭,后期主要死于多臟器功能衰竭。結(jié)論嚴(yán)重創(chuàng)傷病人在ICU治療期間應(yīng)密切觀察病情變化,及時診斷需要手術(shù)解決的繼發(fā)性病變,一旦確定應(yīng)及時手術(shù)治療;行損害控制手術(shù)的病人需進(jìn)一步完善診斷,盡量在48小時內(nèi)行確定性手術(shù),對全身情況不穩(wěn)定、傷情復(fù)雜的病人,宜行分期多次手術(shù)。

  本文關(guān)鍵詞：損傷控制外科理論在腹部外科擇期手術(shù)中的應(yīng)用，由筆耕文化傳播整理發(fā)布。