Application of injury control resuscitation in hemodynamically unstable pelvic fractures
Objective:To explore the application and significance of Damage Control Recovery(DCR)technique in hemodynamically unstable pelvic fractures.Methods:A retrospective analysis was conducted on the clinical data of 76 patients with hemodynamically unstable pelvic fractures treated from March 2019 to March 2023.After admission,all 76 patients were treated with venous access,blood transfusion,controlled surgery,fluid replacement and volume expansion.According to different resuscitation methods,the patients were divided into injury control resuscitation group(treatment group,40 cases)and traditional positive pressure resuscitation group(control group,36 cases).The infusion volume of colloidal solution,crystal solution,red blood cells,plasma,and platelets within 24 hours between the treatment group and the control group was compared,and the recovery time of PT/APTT,temperature recovery time,lactate clearance time,patient death,and DIC occurrence were recorded.Results:There was no statistically significant difference(P>0.05)in the basic information,cause of injury,degree of shock,and type of fracture between the two groups of patients.The control group received significantly more red blood cell suspension,crystal fluid,and colloid fluid infusion than the treatment group,while the control group received less plasma and platelets infusion than the treatment group.The mortality rate of the treatment group was significantly lower than that of the control group,and the difference between the two groups was statistically significant(P<0.05).The incidence rate of DIC in the control group was significantly higher than that in the treatment group.The recovery time of coagulation function,lactate clearance and body temperature in the control group were significantly longer than those in the treatment group(P<0.05).Conclusion:For patients with hemodynamically unstable pelvic fractures,timely adoption of damage control resuscitation(DCR)strategy in the early stage of injury can improve the recovery effect and rescue success rate.DCR solves the key problem of early recovery in patients with severe pelvic fractures and creates strong conditions for further surgical treatment.
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