急诊救治严重创伤314例分析_医学论文.docVIP

急诊救治严重创伤314例分析_医学论文 急诊救治严重创伤314例分析_医学论文 作者：胡爱民，关小宏，商玉兰，张世杰，张中东 【关键词】 创伤和损伤 Emergency treatment of 314 cases of severe trauma　　【Abstract】 AIM: To retrospectively analyze cases of severe trauma in order to provide some constructive suggestions for trauma emergency treatment in urban areas. METHODS: The retrospective analysis was conducted in 314 severe trauma cases who were admitted to the Emergency Surgical Department from August 2000 to July 2005. RESULTS: There were 236 male and 78 female patients with a mean age of 33.8 years old (range 877 years). The mean trauma score (TS) was 13.4±3.5, the mean Glasgow Coma Score (GCS) was 12.4±3.6 and the mean Injury Severity Score (ISS) was 20.1±11.7. There were 152 cases (48.4%) with multiple injuries and 253 cases with shock. The survival rate was 94% and the rescue success rate was 89%. Definite emergency surgery was carried out in 261 cases. The causes of trauma were traffic accident (163, 52%), fight with weapons and injuries at work sites (93, 30%) and falling (58, 18%). The mean hospitalization duration in the emergency department was (54±28) min for the survival cases and (121±48) min for the dead cases, with a very significant difference between the 2 groups （P＜0.01）. CONCLUSION: Traffic accident, fight with weapons and injuries at work sites and falling are the major causes of severe trauma in urban areas. Shortening the duration of staying in the emergency department and early definite emergency surgery can effectively improve the success rate. 　　【Keywords】 cities wounds and injuries first aid 　　【摘要】 目的： 对严重创伤病例进行回顾性分析，并对城市中常见的创伤急救提出建设性意见. 方法： 对200008/200507急诊危重病例中筛选出急需抢救的严重创伤314例进行分析. 结果： 男性236，女性78例，年龄33.8（8~77）岁；创伤评分（TS）13.4±3.5；格拉斯哥昏迷评分（GCS）12.4±3.6；创伤严重程度评分（ISS）20.1±11.7；多发伤152例（48.4%）. 病因： 交通伤163例（52%）；斗殴、工伤93例（30%）；坠落伤58例（18%）. 休克253例，脱险率94%，抢救成功率89%. 实施确定性抢救手术261例. 急诊滞留时间： 抢救脱险组（54±28） min，死亡组（121±48） min，两组有统计学差异（0.01）. 结论： 交通伤、斗殴、工伤、坠落伤是城市严重创伤的主要原因，缩短急诊滞留时间，早期实施确定性治疗，可以有效地提高抢救成功率. 　　【关键词】 城市；创伤和损伤；急救