嚴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：目的 观察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。方法 回顾分析我院62例严重多发伤患者的临床资料，其中有胃肠功能障碍的24例，无胃肠道功能障碍的38例，这些患者收住或转入我院中心ICU治疗的23例，其他科室收治的39例。分析这些患者的急性生理和慢性健康状况评分(APACHEⅡ)、创伤严重度评分(ISS)、多器官功能障碍综合征(MODS)发生率和死亡率，并比较组间的差异。结果62例患者有24例(38.7％)发生胃肠功能障碍，其APACHEⅡ评分、ISS评分和MODS发生率与无胃肠功能障碍组相比均明显升高；ICU收治患者的胃肠功能障碍发生率明显低于其他科室。结论 严重多发伤患者出现胃肠功能障碍提示患者病情严重，采用整体化观念的综合治疗措施可以改善胃肠功能，提高疗效。 关键词：严重多发伤；胃肠功能障碍；多器官功能障碍综合征；综合治疗 中图分类号： 文献标识码： Clinical 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％) occurred 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