ICU复苏在严重创伤控制性手术中的临床价值

目的探讨ICU复苏在严重创伤控制性手术（DCS）中的应用价值。方法2003年1月至2007年12月收治的33例严重创伤患者采用I期确定性手术，为传统手术组；2008年1月至2013年4月收治的40例严重创伤患者采取损伤控制性手术，为DCS组。对比DCS组复苏后与传统手术组乳酸水平、凝血时间、pH值、体温，并比较两组死亡率，分析和评价DCS的临床价值。结果与传统手术组比较，DCS组ICU复苏后血乳酸水平、pH值、体温、凝血时间明显改善（P〈0．05）。传统手术组痊愈出院18例，死亡15例；DCS组患者痊愈33例，死亡7例。DCS组死亡率明显低于传统手术组（P〈0．05）。结论严重创伤患者及时采取DCS和有效地ICU复苏，能显著提高救治成功率，降低死亡率。死亡率降低可能与ICU复苏后乳酸水平、凝血时间、pH值、体温等显著改善有关。

Clinical value of resuscitation of intensive care unit in damage control surgery for severe trauma

Objective To explore the value of resuscitation of intensive care unit （ICU） in dam- age control surgery （DCS） for severe trauma. Methods A total of 33 cases of severe trauma received pri- mary definitive operation from January 2003 to December 2007 （ traditional group） , and another 40 cases with severe trauma received DCS from January 2008 to June 2013 （DCS group）. The lactate level, pro- thrombin time（PT） , pH value, body temperature and mortality rate were analysed and compared between the groups. Results The lactate level, pH value, body temperature and PT in the DCS group were signifi- cantly improved（P 〈 0.05 ）. In the traditional group, 18 cases were cured and 15 cases died. In the DCS group,33 cases were cured and 7 cases died. The mortality rate in the DCS group was significantly lower than that in the traditional group （ P 〈 0.05 ）. Conclusion The DCS and ICU resuscitation can improve the successful rate and reduce the mortality rate for patients with severe trauma. The reducing of mortality rate may relate with the improvement of lactate level, PT, pH value and body temperature.