一体化救治模式并行早期创伤控制性手术对严重多发伤患者救治效果研究.docVIP

一体化救治模式并行早期创伤控制性手术对严重多发伤患者救治效果的研究 　　[摘要] 目的 探讨采用一体化救治模式（ITM）并行早期创伤控制性手术（DCS）对严重多发伤患者的救治效果。 方法 对达州市中心医院2011年10月～2013年8月救治的53例严重多发伤患者采用ITM及行DCS救治的临床资料进行回顾性分析。 结果 53例严重多发伤患者，存活46例（86.8％），病死7例，病死率13.2％，其中就诊救治时间≤1 h的病死2例（6.3％），＞1 h的病死5例（23.8％），经比较差异有统计学意义（P 0.05），与病死患者比较，存活患者组损伤严重程度评分较低，差异有统计学意义（P 0.05）。 结论 ITM并行DCS对严重多发伤患者的救治效果显著,能够明显减少并发症发生率，降低病死率，提高患者生存率及生存质量，改善其预后。 　　[关键词] 多发伤；急诊；一体化救治模式；创伤控制性手术；效果 　　[中图分类号] R641[文献标识码] A[文章编号] 1673-7210（2014）05（a）-0036-03 　　 　　Effect research integrated treatment mode with early damage control surgery treating for severe multiple injury patients 　　YOU Jianchuan ZENG Lingxiong ZHANG Tingjiu 　　Central Hospital of Dazhou City, Sichuan Province, Dazhou 635000, China 　　[Abstract] Objective To discuss the effect of integrated treatment model (ITM) with damage control surgery (DCS) treating for severe multiple injury patients. Methods In Central Hospital of Dazhou City, from October 2011 to August 2013, 53 cases of severe multiple injury were given ITM with early DCS treatment, the clinical data were retrospectively analyzed. Results 53 patients with severe multiple injury, survived 46 cases (86.8%), 7 cases died, mortality rate were 13.2%, Among the patiens of the seeing a doctor and treatment time≤1 h, there were 2 cases died(6.3%), the seeing a doctor and treatment time 1 h, there were 5 cases died (23.8%), the difference was statistically significant (P 0.05). The injury severity score of survival patiens were lower than those of dead patiens, the difference was statistically significant (P 0.05). Conclusion The effect ITM with early DCS treating forpatients with severe multiple injury can significantly reduce the incidence of complications and mortality, improve patient survival, quality of life and the prognosis. 　　[Key words] Multiple injury; Emergency; Integrated treatment mode; Damage control surgery; Effect 　　随着我国经济的高速发展，特别是高速道路的发展及机动车辆的普及、超高层建筑的增多，使得交通事故和工伤事故等各类意外创伤事件呈多发趋势，其中严重多发伤的比例明显增加，且多数属于高能量损伤。多发性创伤是指在同一致伤因素作