多发伤早期救治中64层螺旋CT的应用.docVIP

多发伤早期救治中64层螺旋CT的应用* 重庆第三军医大学大坪医院野战外科研究所全军战创伤中心（400042） 张连阳 姚元章 王 韬 刘朝普 李英才 张 宇 黄显凯 何奇元 张伟国 王 毅 陈 蓉 【摘要】 目的 探讨64层螺旋CT在多发伤早期救治中的作用。方法 回顾性分析2006年1月～2007年10月间救治的284例多发伤，男232 例，女52 例；年龄平均34.5岁。头颈伤54例次，面部伤35例次，胸部伤125例次，腹部伤112例次，骨盆及四肢伤104例次，体表伤254例次。合并休克103例次。ISS 10～54分，平均16.3分。37例因伤情过重直接送入手术室，247例到院后3小时内64层螺旋CT检查。结果 螺旋CT检查时间8.4分钟。21例初检时有漏诊。急诊手术154例，其中启动绿色通道74例，非手术治疗130例。治愈272例（95.8％）；死亡12例（4.2％）。结论 多发伤早期救治中应用64层螺旋CT有助于缩短院内术前时间，提高早期确诊率和救治水平。 【关键词】多发伤；64层螺旋CT；早期救治 Application of 64-slice helical CT in early treatment of multiple trauma ZHANG Lian-yang, YAO Yuan-zhang, WANG Tao, LIU Zhao-pu, LI Ying-cai, ZHANG Yu, HUANG Xian-kai, HE Qi-yuan, ZHANG Wei-guo, WANG Yi, CHEN Rong （Trauma Center of PLA, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China） Abstract: Objective: To discuss the role of 64-slice helical CT in treatment of multiple trauma. Methods: A retrospective study was carried out on 284 case of multiple trauma including 232 males and 52 females (with average age of 34.5 years) admitted from January 2006 to October 2007. Injury sites and injury frequency were distributed at head and neck in 54 cases (times), face in 35, thoracic region in 125, abdomen in 112, pelvis and extremities in 104 and body surface in 254. Of all, 103 cases (times) were combined with shock. ISS was 10-54 points, mean 16.3 points. Of all, 37 cases were sent for operation directly because of severe injury, the other 247 cases were examined with 64- slice helical CT within 3 hours after admission, Results: Mean time of examined with 64-slice helical CT was 8.4 minutes. Missed diagnosis happened in 21 cases. Emergency operation was done in 154 cases, of which 74 cases received operation via free channel. A total of 130 cases were treated non-surgically. Of all, 272 cases (95.8％) survived but 12 (4.2％) died. Conclusion: Application of 64-row helical CT in early treatment of multiple trauma is helpful for shortening preope