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Damage control orthopaedics: lessons learned

机译:伤害控制骨科:经验教训

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摘要

Damage control orthopaedics (DCO) is a staged approach for the management of multiply injured patients. It is ideal for trauma patients presenting in an unstable or extremis physiological state. It focuses on the rapid resuscitation of these patients by providing temporary stabilisation of fractures while at the same time reducing the biological load of surgery. Early findings support its usefulness in controlling the lethal triad of hypothermia, acidosis and coagulopathy. Furthermore, recent evidence indicates that it regulates the evolving systemic inflammatory response, reducing the detrimental complications of adult respiratory distress syndrome, multiple organ dysfunction and subsequent mortality. Although DCO has been proven a useful surgical strategy for efficiently managing patients with multiple trauma, further work is required to establish fully its indications, results and cost implications.
机译:损伤控制骨科(DCO)是管理多发伤患者的分阶段方法。对于处于不稳定或极端生理状态的创伤患者来说,它是理想的选择。它着重于通过临时稳定骨折同时减少手术的生物负荷来对这些患者进行快速复苏。早期发现支持其在控制体温过低,酸中毒和凝血病的致死三联症方面的有用性。此外,最近的证据表明,它可以调节不断发展的全身炎症反应,减少成人呼吸窘迫综合征,多器官功能障碍和随后的死亡率的有害并发症。尽管已证明DCO是有效管理患有多种创伤的患者的有用手术策略,但仍需要进一步的工作来充分确定其适应症,结果和成本影响。

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