骨科損傷控制對(duì)骨盆骨折伴四肢多發(fā)性骨折患者的治療效果觀察

李紅橋

【摘要】 目的：觀察骨科損傷控制（DCO）對(duì)骨盆骨折伴四肢多發(fā)性骨折患者的臨床療效，并分析對(duì)患者凝血功能的影響。方法：選取2016年7月-2017年7月本院收治的骨盆骨折伴四肢多發(fā)性骨折患者88例。按照隨機(jī)數(shù)字表法將其分為A組和B組，各44例。A組在DCO理念下進(jìn)行分期治療，B組采用常規(guī)方案治療。觀察兩組手術(shù)指標(biāo)、手術(shù)效果、并發(fā)癥及治療前后的凝血功能指標(biāo)。結(jié)果：A組手術(shù)時(shí)間、術(shù)中出血量、體溫恢復(fù)及骨痂生成時(shí)間均少于B組，比較差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；術(shù)后7 d，兩組PT、APT、TT水平均高于術(shù)前，F(xiàn)ib水平均低于術(shù)前，且A組PT、APT、TT水平均高于B組，F(xiàn)ib水平低于B組，比較差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；B組優(yōu)良率為81.82%，明顯高于B組的63.64%（P<0.05）；A組并發(fā)癥發(fā)生率為6.82%，明顯低于A組的20.45%（P<0.05）。結(jié)論：基于DCO理念對(duì)骨盆伴四肢多發(fā)性骨折患者進(jìn)行分期治療，骨折復(fù)位良好，更利于術(shù)后功能恢復(fù)，同時(shí)能夠快速糾正患者的乳酸水平，改善其凝血功能，減少術(shù)后并發(fā)癥，較傳統(tǒng)治療更有優(yōu)勢(shì)。

【關(guān)鍵詞】 骨盆骨折； 四肢多發(fā)性骨折； 骨科損傷控制

Observation of Treatment Effect of Department of Orthopedics Injury Control for the Patients with Pelvic Fracture Complicated with Multiple Fractures of the Extremities/LI Hongqiao.//Medical Innovation of China，2018，15（17）：0-030

【Abstract】 Objective：To observe the clinical effects of department of orthopedics injury control for the patients with pelvic fracture complicated with multiple fractures of the extremities，and to analyze the effect on coagulation function of patients.Method：A total of 88 patients with pelvic fracture complicated with multiple fractures of the extremities admitted to our hospital from July 2016 to July 2017 were selected.According to the random number table method，they were divided into group A and group B，44 cases in each group.Group A was treated by stages according to DCO concept，while group B was treated by routine treatment.The operative index，operative effect，complications and coagulation function before and after treatment between two groups were compared.Result：The operative time，intraoperative blood loss，recovery of body temperature and callus formation time in group A were less than those of group B，the differences were statistically significant（P<0.05）.After operation 7 d，the levels of PT，APT and TT in two groups were all higher than those before operation，the level of Fib was lower than that before operation，and the levels of PT，APT and TT in group A were higher than those of group B，the level of Fib was lower than that of group B，the differences were statistically significant（P<0.05）.The excellent and good rate in group A was 81.82%，which was significantly higher than 63.64% in group B（P<0.05）.The incidence of complications in group A was 6.82%，which was significantly lower than 20.45% in group B（P<0.05）.Conclusion：Based on the DCO concept，the patients with multiple fractures of the extremities of the pelvis are treated by stages，and the fracture reduction is good，it is more beneficial to the recovery of postoperative function，and it can quickly correct the lactic acid level of the patients，improve the coagulation function and reduce the postoperative complications，which is more advantageous than the traditional treatment.