| 杨永飞,孙运秀,郭方圆,蔡 钧,杨世疆.损伤控制手术对严重胸腹联合伤患者胃肠功能及血清炎症因子水平的影响[J].,2017,17(17):3267-3269 |
| 损伤控制手术对严重胸腹联合伤患者胃肠功能及血清炎症因子水平的影响 |
| Effects of Damage Control Surgery on Gastrointestinal Functions and Serum Levels of Inflammatory Factors of Patients with Thoraco-abdominal Injury |
| 投稿时间：2016-12-12 修订日期：2016-12-28 |
| DOI：10.13241/j.cnki.pmb.2017.17.016 |
| 中文关键词: 胸腹联合伤 损伤控制手术 胃肠功能 炎症因子 |
| 英文关键词: Thoraco-abdominal injury Damage control surgery Gastrointestinal functions Inflammatory factors |
| 基金项目:湖北省自然科学基金项目(2011CD96) |
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| 中文摘要: |
| 摘要 目的：探讨损伤控制手术治疗严重胸腹联合伤患者的临床观察及对患者胃肠功能的影响。方法：选择2014年9月至2016年9月我院接诊的96例严重胸腹联合伤患者，通过随机数表法分为观察组（n=48）和对照组（n=48）。对照组行确定性手术，观察组行损伤控制性手术。观察并比较两组患者手术时间、术中出血量、血清肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）及C反应蛋白（CRP）水平、排便时间、排气时间、肠鸣音恢复时间、进食时间及术后并发症的发生情况。结果：观察组手术时间短于对照组，术中出血量少于对照组（P＜0.05）；观察组患者血清肿瘤坏死因子-α （TNF-α）、白介素-6（IL-6）及C反应蛋白（CRP）水平均低于对照组（P＜0.05）；观察组排便时间、排气时间、肠鸣音恢复时间及进食时间均早于对照组（P＜0.05）；观察组术后并发症发生率低于对照组（P＜0.05）；观察组死亡率低于对照组（P＜0.05）。结论：在严重胸腹联合伤患者中实施损伤控制手术效果显著，可促进术后胃肠功能的恢复，减少并发症，降低死亡率，值得应用推广。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effects of damage control surgery on the gastrointestinal functions and serum levels of inflam- matory factors of patients with thoraco-abdominal injury. Methods: 98 patients with thoraco-abdominal injury who were treated in our hospital from September 2014 to September 2016 were selected and randomly divided into the observation group (n=48) and the control group (n=48). The patients in the control group were treated with definitive surgery, while the patients in the observation group were treated with damage control surgery. Then the operation time, blood loss, the serum levels of TNF-α, IL-6 and CRP, the time of defeca- tion, exhaustation, bowel sound recovery and eating, and the incidence of postoperative complications in the two groups were observed and compared. Results: The operation time in the observation group was shorter than that of the control group, and the blood loss was less than that of the control group (P<0.05); After surgery, the serum levels of TNF-α, IL-6 and CRP in the observation group were lower than those of the control group (P<0.05); The time of defecation, exhaustation, bowel sound recovery and eating in the observation group were shorter than those of the control group (P<0.05); The incidence of postoperative complications in the observation group was lower than that of the control group (P<0.05); The mortality rate of the observation group was lower than that of the control group (P<0.05). Conclusion: Damage control surgery has better clinical effects on the treatment of thoraco-abdominal injury, which can promote the re- covery of gastrointestinal functions, and reduce the serum levels of inflammatory factors, and it's worthy of clinical application and pro- motion. |
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