《多发骨创伤的诊断与治疗循证指南（2026）》解读

Interpretation of Evidence-based Guidelines for Diagnosis and Treatment of Bone Polytrauma（2026）

摘要

2026年5月，《多发骨创伤的诊断与治疗循证指南（2026）》在《中华创伤骨科杂志》和《骨科临床与研究杂志》同期发表。该指南按照循证指南制订流程，由创伤骨科及急诊、重症医学、麻醉、血管外科、神经外科、胸外科、普通外科、康复等相关专业人员共同参与制订，围绕多发骨创伤的定义与分级、诊断评估、多系统损伤管理、多学科协作、手术时机、早期全面治疗与损伤控制骨科选择、局部骨折处理、并发症预防及康复等内容形成29条推荐意见。本文对指南制订特点、推荐意见总体框架及临床应用中容易产生歧义的重点问题进行解读，以帮助临床医生准确理解并合理应用指南。

Abstract

The Evidence-based Guidelines for Diagnosis and Treatment of Bone Polytrauma（2026） were simultaneously published in May 2026 in Chinese Journal of Orthopaedic Trauma and Journal of Clinical Orthopedics and Research. The guidelines were developed through a standardized evidence-based process with participation from orthopaedic trauma, emergency medicine, critical care, anesthesiology, vascular surgery, neurosurgery, thoracic surgery, general surgery, rehabilitation and other related disciplines. Twenty-nine recommendations cover the definition and grading of bone polytrauma, diagnostic assessment, management of concomitant systemic injuries, multidisciplinary teamwork, timing and sequencing of surgery, selection between early total care and damage control orthopaedics, local fracture management, prevention of complications, and rehabilitation. This article interprets the development characteristics, overall framework, and major issues that may lead to ambiguity in clinical practice.

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