Application of damage control surgery in the treatment of severe liver trauma patients

Abstract

Objective To investigate the clinical application and nursing effect of damage control surgery （ DCS ） in treating patients with severe liver trauma .Methods A retrospective study was used to investigate 83 patients with severe liver trauma （ grade Ⅳ, and Ⅴ） from January 2008 to December 2012 associated with the lethal triad of coagulopathy , hypothermia , and acidosis treated by DCS .Nursing intervention included fluid resuscitation , care of lethal triad and postoperative complications .And the control group was 31 patients with liver trauma of grade Ⅳand Ⅴwho had be treated without DCS .Results The mortality rate was 25.3%and 51.6% in the DCS group and the control group , and the difference was statistically significant （χ2 =7.13, P<0.01）.The main cause of death was coagulopathy .The incidence of abdominal compartment syndrome was respectively 6.0% and 19.4% in the DCS group and the control group , the incidence of subdiaphragmatic abscess was 7.2%and 22.6%, and the differences were statistically significant （χ2 =4.60, 5.27, respectively;P<0.05）.Conclusions DCS for patients with severe liver trauma can obviously increase their survival rate .The point of nursing intervention was limited fluid resuscitation before the surgery , correction of coagulopathy , hypothermia and acidosis during ICU as well as prevention and management of postoperative complications after the surgery . Key words: Damage control; Liver trauma; Coagulopathy; Nursing intervention