严重多发伤患者胃肠功能障碍的临床分析.docVIP

严重多发伤患者胃肠功能障碍的临床分析 陈 彦 项 炜 王大明 刘 宁 （苏州大学附属第三医院 急诊科，江苏常州 213003） 作者介绍：陈 彦（1977-），男，江苏常州人，主治医师，医学硕士，主要从事急诊和重症医学专业 摘要：％analysis of gastrointestinal dysfunction in severe multiple trauma patients CHEN Yan，XIANG Wei，WANG Da-Ming，LIU Ning （Department of Emergency，the Third Affiliated Hospital of Soochow University， Jiangsu Changzhou 213003，CHINA） Abstract: Objective To observe the relationship between gastrointestinal dysfunction and the condition of severe multiple trauma patients，then to explore the influence of different treatment modalities on survival of patients.Methods 62 severe multiple trauma patients were studied retrospectively，among them 24 cases had gastrointestinal dysfunction，and the other 38 cases did not have. 23 cases were admitted to intensive care unit(ICU)，and 39 cases were admitted to other departments. The APACHE - II score、ISS score、MODS rate and mortality of these patients were analyzed to compare the difference between groups. Results Among 62 severe multiple trauma patients，24 cases(38.7％)gastrointestinal dysfunction. The APACHE - II score、ISS score、MODS rate and mortality of gastrointestinal dysfunction patients were significantly higher than non-gastrointestinal dysfunction patients.And the gastrointestinal dysfunction rate of patients that admitted to ICU were remarkably lower than patients admitted to other departments. Conclusions Severe multiple trauma patients with gastrointestinal dysfunction indicates serious in patients conditions. Comprehensive treatment based on organic wholeness can improve the function of gastro-intestine and increase the curative effect. Keywords: severe multiple trauma；gastrointestinal dysfunction；MODS；comprehensive treatment 多发伤患者通常伤情严重，病情复杂，而这些患者一旦出现胃肠道功能障碍，则提示病情加重，预后不良。本文总结了我院2008年6月至2010年6月期间收治的62例严重多发伤患者的临床资料，研究胃肠功能障碍和严重多发伤患者病情之间的关系，并探讨不同治疗模式对患者预后的影响。 1 临床资料 1.1 一般资料 选取我院2008年6月~2010年6月收治的62例严重多发伤患者，男47例，女15例；年龄15~81岁，平均年龄37.5岁。受伤部位：脑外伤41例，胸外伤15例，腹部外伤27例，骨盆骨折23例，四肢骨折32例，脊柱损伤5例；其中两处伤患者35例，三处及以上伤患者27例