首页|颅脑外伤合并多发伤患者早期处置及临床数据特征分析

颅脑外伤合并多发伤患者早期处置及临床数据特征分析

Early management of patients with traumatic brain and multiple injuries and their clinical data characteristics

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目的:探讨创伤性脑损伤合并多发伤患者的特点,并分析其与预后的相关性,以提高多发伤患者的救治成功率。方法:收集2018年1月至2019年12月苏州高新区人民医院急诊科收住ICU的创伤性脑损伤合并多发伤的112例患者,其中男性75例,女性37例;年龄11~87岁,平均(46.6±17.2)岁。损伤严重度评分(ISS)[2]5~57分,平均(17.7±10.8)分,损伤合并其他部位包括:胸(73例)、腹(15例)、脊柱(25例)、四肢(26例)、骨盆(11例)、五官(15例)。统计患者的ISS、急诊抢救室滞留时间、是否手术、入住ICU后APACHEⅡ评分[3]、入住ICU的时间以及28 d病死率。结果:根据Logistic回归分析,患者入住ICU的时间长短与患者年龄、ISS评分、是否手术治疗均有显著影响,而与抢救室滞留时间无显著影响;患者的28 d病死率与ISS评分有显著影响,而与患者年龄、是否手术、抢救室滞留时间无显著影响(P>0.05)。结论:ISS评分在指导创伤性脑损伤合并多发伤患者的抢救时具有指导意义,在具有完善的创伤中心建制的医疗机构,不能盲目的要求缩短抢救室滞留时间,对于患者病情评判及早期处置才是重要的。
Objective:To investigate the characteristics of patients with traumatic brain injury complicated with multiple injuries, and to analyze its correlation with prognosis, so as to improve the success rate of treatment in patients with multiple injuries.Methods:From January 2018 to December 2019, 112 patients with traumatic brain injury combined with multiple injuries admitted to the ICU in the emergency department of the People’s Hospital of SND were collected, including 75 males and 37 females. The age ranged from 11 to 87 years, with a mean of (46.6±17.2) years. The injury severity score (ISS) was 5-57, with a mean of (17.7±10.8) points. The other sites involved in the injury included: chest(73 cases), abdomen (15 cases), spine (25 cases), limbs (26 cases), pelvis (11 cases), and facial features (15 cases). The patients’ ISS score, stay time in emergency room, operation or not, APACHEⅡ score after ICU admission, time of ICU admission, and 28-day mortality were analyzed.Results:According to Logistic regression analysis, the length of stay in ICU had significantly positive effects on patient age, ISS score and whether or not surgery was performed, but no significant impact on stay time in emergency room. The 28-day mortality of patients had significantly positive effects on ISS score, but no significant effects on age, operation or stay time in emergency room(P>0.05).Conclusion:ISS score plays a guiding role in the rescue of patients with traumatic brain injury complicated with multiple injuries. In addition, in medical institutions with a sound trauma center system, it is important for the evaluation and early treatment of patients’ condition that the stay time in the emergency room should not be shortened blindly.

梅冬兰、罗婧、凌受毅、高山、陶宗明、孙志辉

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215129 江苏苏州,苏州高新区人民医院急诊科

215129 江苏苏州,苏州高新区人民医院神经外科

215129 江苏苏州,苏州高新区人民医院国际医学部

急诊 颅脑外伤 早期处置 数据分析

2023

中华卫生应急电子杂志

中华卫生应急电子杂志

ISSN:
年,卷(期):2023.9(4)
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