The Effect Of Injury Control Surgery On Unstable Pelvic Fractures On Coagulation Function And Prognosis Of Patients

ObjectiveTo investigate the effect of injury control surgery on unstable pelvic fractures on coagulation function and prognosis of patients.MethodsA retrospective analysis was carried to 60 patients with pelvic fractures admitted to Zhengzhou Central Hospital affiliated to Zhengzhou University from June 2015 to March 2019,which were divided into DCO group and routine group according to whether the DCO concept was applied.There were 32 cases in the DCO group.Of which 32,there were 21 males and 11 females,aged(23～61)years old,with an average age of(46.34 ± 9.85)years.According to the Tile classification,20 cases had Tile B fractures,12 cases had Tile C fractures,and the ISS score was(19～35)points,with an average of(27.09 ± 3.90)points,including 20 cases with injuries caused by car accidents,9 cases with fall injuries,3 cases with heavy injuries,8 cases with brain injuries,6 cases with chest and abdomen injuries,and 17 cases with fractures of other parts,the time from injury to admission was(0.5～10)hours,with an average of(1.97±1.59)hours.There were 28 cases in the routine group,including 17 males and 11 females,aged(18～70)years old,with an average of age(43.64 ± 13.43)years old.According to Tile classification,18 cases with Tile B fractures,10 cases with Tile C fractures,and the ISS score was(18～34)points,with an average of(25.71 ± 4.24)points,including 19 cases with injuries caused by car accidents,7 cases with fall injuries,2 cases with heavy injuries,8 cases with brain injuries,7 cases with chest and abdomen injuries,and 15 cases with fractures of other parts,and the time from injury to admission was(0.5～7)hours,with an average of(1.75±1.48)hours.The preoperative general data,operation time,intraoperative bleeding volume,blood transfusion volume,ICU days,hospitalization time,preoperative and postoperative 3 days coagulation function were compared between the two groups.The reduction of the two groups was evaluated according to the Matta standard,and the Majeed scores at the last follow-up were calculated.ResultsThere was no significant difference in the general information and blood transfusion volume between the two groups of patients.The operation time of the DCO group and the conventional group were(93.38 ± 22.60)min、(123.50± 33.88)min,the intraoperative blood loss of the DCO group and the conventional group were(205.63±126.39)ml、(275.00±120.57)ml,the ICU days of the DCO group and the conventional group were(6.41 ± 3.66)days、(8.93 ± 4.90)days,the length of hospital stay of the DCO group and the conventional group were(16.75 ± 3.91)days、(22.71±4.00)days.The difference of operation time、intraoperative blood loss、ICU days and hospitalization time between the two groups were statistically significant(P<0.05).At 3 days after operation,PT,APTT,and TT in the DCO group were higher than those in the conventional group(P<0.05),while Fib was lower than routine group(P<0.05).Matta score:excellent rate in the DCO group(90.63%),excellent rate in the conventional group(85.71%),excellent rate in the DCO group is significantly greater than the conventional group,but there is no statistical difference(P>0.05).Majeed Score:DCO group(88.75 ± 5.71)points,routine group(80.04±6.34)points,the results of the two groups are statistically different(P<0.05).ConclusionApplying the concept of injury control to patients with unstable pelvic fractures can improve the patient’s coagulation function and the patient’s prognosis.