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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。
OBJECTIVE: To investigate the clinical observation of injury control surgery in patients with severe thoraco-abdominal injuries and its effect on gastrointestinal function. Methods: A total of 96 patients with severe thoracoabdominal and abdominal injuries admitted to our hospital from September 2014 to September 2016 were selected and divided into observation group (n = 48) and control group (n = 48) by random number table. The control group underwent definite surgery, and the observation group underwent controlled injury surgery. The operative time, intraoperative blood loss, levels of serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP), defecation time, Bowel sounds recovery time, eating time and postoperative complications. Results: The operation time in the observation group was shorter than that in the control group, and the blood loss in the operation group was less than that in the control group (P <0.05). The serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (P <0.05). The defecation time, exhaust time, bowel sounds recovery time and eating time in the observation group were earlier than those in the control group (P <0.05). The postoperative complications The incidence of disease was lower than that of the control group (P <0.05). The mortality of the observation group was lower than that of the control group (P <0.05). Conclusion: The effect of injury control surgery in patients with severe thoracoabdominal injuries is significant, which can promote the recovery of postoperative gastrointestinal function, reduce complications and reduce mortality, which is worthy of popularization.