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目的筛选分析严重腹部创伤患者死亡危险因素。方法收集2000年1月—2008年12月第三军医大学西南医院严重腹部创伤并行剖腹手术救治的192例的临床资料,回顾分析所有患者入院时生命体征、创伤评估、主要实验室检查结果、临床救治情况。根据救治的最终结局,将患者分为存活组和死亡组,比较分析两组不同指标间的差异。结果通过手术、液体复苏和对症支持治疗,192例成功救治175例,救治成功率91.15%;死亡17例,病死率8.85%,死亡主要原因为休克、重型颅脑损伤和脓毒症。脉搏、收缩压、伤情评估指标、白细胞、血红蛋白、红细胞压积、血小板、凝血酶原时间、血糖、伤后来院时间、手术次数、输血量及住院时间比较差异均有统计学意义(P<0.05或P<0.01)。结论严重腹部创伤患者死亡除与伤情严重程度直接相关外,还与其生理状态恶化及继发性病理生理学改变密切相关,及时纠正并阻断病情恶化对挽救患者生命具有重要的意义。
Objective To screen for the risk factors of death in patients with severe abdominal trauma. Methods The clinical data of 192 cases with severe abdominal trauma and laparotomy in Southwest Hospital of the Third Military Medical University collected from January 2000 to December 2008 were retrospectively analyzed. All the patients were retrospectively analyzed for vital signs, trauma assessment, major laboratory findings, clinical Treatment situation. According to the final outcome of treatment, the patients were divided into survival group and death group, and the differences between the two groups were compared. Results After operation, liquid resuscitation and symptomatic supportive treatment, 175 cases were successfully treated in 192 cases, the success rate was 91.15%, 17 cases died and the case fatality rate was 8.85%. The main causes of death were shock, severe craniocerebral injury and sepsis. Pulse, systolic blood pressure, injury evaluation index, white blood cells, hemoglobin, hematocrit, platelets, prothrombin time, blood glucose, hospital stay after injury, the number of surgery, blood transfusion and length of stay were significantly different (P < 0.05 or P <0.01). Conclusion The death of patients with severe abdominal trauma is directly related to the severity of the injury, but also to the deterioration of their physiological status and secondary pathophysiological changes. It is of great significance to correct and stop the deterioration of the disease in time to save the lives of patients.