2009年10月7日 星期三

何謂 DCS?

What is meant by “damage-control surgery”?

If a patient had hypothermia, acidosis, and diffuse bleeding during the first laparotomy, the surgical team will opt for a damage-control strategy. The term “damage control” originated in the U.S. Navy and referred to the ability of a ship to absorb damage while continuing to perform its mission. Damage-control laparotomy is widely practiced today in severely injured patients with trauma. The basic concept is to perform an abbreviated operation, focusing on controlling hemorrhage and contamination. This initial operation is followed by a period of resuscitation in the intensive care unit (ICU) to reverse the lethal triad of acidosis, hypothermia, and coagulopathy. The patients are taken back to the operating room for a definitive operation once the physiological disturbances have been corrected. Although used primarily for severely injured patients, this approach is equally useful for other critically ill patients who need an operation.

New England Journal of Medicine - Vol. 361, No. 15, October 8, 2009

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