摘要
目的分析急诊多发伤患者死亡的相关因素以及独立危险因素。方法回顾性分析本院急诊2012年6月—2015年6月救治的651例严重多发伤患者资料,根据患者结局分为成功组(608例)与死亡组(43例),比较2组患者性别、年龄、致伤原因、与本次外伤相关的原发疾病、损伤程度评分法(ISS)评分、创伤数量、受伤至就诊时间以及受伤部位等指标差异,并采用Logistic回归分析患者死亡的危险因素。结果死亡组年龄≥60岁、ISS评分≥16分、创伤数量≥4处、颅脑有主要损伤以及受伤至就诊时间≥3 h比例均高于成功组(均P<0.05)。患者年龄≥60岁、受伤部位(颅脑)、ISS评分≥16分和受伤至就诊时间≥3 h为多发伤病患急诊死亡的独立危险因素。死亡组患者致死原因以脑挫裂型颅脑创伤占比最高,达27.91%(12例),颅内血肿占20.93%(9例),创伤型血胸占11.63%(5例)。结论上述独立危险因素应引起急诊医生的重点关注,据此制定急救预案,以降低多发伤病患者的死亡率。
Objective To analyze the related factors and the independent risk factors of death in patients with multipleinjuries.Methods Data of651patients with multiple injuries treated in our hospital from June2012to June2015wereretrospectively analyzed.According to the outcomes,patients were divided into effective group(n=608)and death group(n=43).Data of gender,age,cause of injury,the primary diseases related with the trauma,ISS score,number of trauma,timefrom injury to the treatment and the body parts of injury were compared between two groups.Logistic regression analysis wasused to analyze the risk factors of death in multiple trauma patients.Results The proportion of patients≥60years old,ISSscore≥16points,the number of trauma≥4,a major brain injury and time of trauma to the treatment≥3h were higher indeath group than those of effective group(P<0.05).The independent risk factors for emergency death in multiple injuriesincluded patients≥60years old,major brain injury,ISS score≥16points and time of trauma to the treatment≥3h.Thecause of death in patients with craniocerebral trauma(cerebral laceration)accounted for up to27.91%(n=12),intracranialhematoma accounted for20.93%(n=9),and traumatic hemothorax accounted for11.63%(n=5).Conclusion The relatedfactors and independent risk factors should be paid attention to doctors in emergency department,and the emergency planshould be made to reduce the death rate of emergency patients with multiple injuries.
作者
王庚壮
潘昭宇
潘立峰
WANG Geng-zhuang;PAN Zhao-yu;PAN Li-feng(Department of General Surgery, the Fourth Affiliated Clinical Hospital of Tianjin Medical University,Tianjin 300140, China;Sophomore 10 Class of Tianjin Experimental Middle School)
出处
《天津医药》
CAS
2017年第8期885-888,共4页
Tianjin Medical Journal
关键词
多处创伤
急诊处理
死亡
危险因素
multiple trauma
emergency treatment
death
risk factors
