腹部创伤器官损伤谱及伤情谱调查分析

Investigation of injury spectrum and traumatic condition spectrum of trauma of abdominal organs

目的 探讨近年来腹部创伤器官损伤谱及伤情谱的变化。 方法 对 1999～ 2 0 0 1年我院收治 2 4 7例腹部创伤器官损伤谱、伤情谱、受伤人员的性别、年龄、职业、伤因等资料进行分析 ,伤情按简明损伤定级标准 -损伤严重度评分 (AIS -ISS)法评分。 结果 1999～ 2 0 0 1年腹部创伤患者分别为 5 4 ,72 ,12 1例。治愈 2 4 1例 ,死亡 6例 ,病死率 2 .5 %。 2 4 7例有 2 92个腹部器官损伤 ,按发生的频率依次为脾 12 6例 (4 3.2 % )、肾 5 5例 (18.8% )、肝 4 0例 (13.7% )、小肠 19例(6 .5 % )、膀胱 14例 (4 .8% )、胰 11例 (3.8% )、结肠 11例 (3.8% ) ,其他分别是胃、十二指肠、直肠。≤ 4 0岁 192例 ,占 77.7%。伤因前三位分别是交通伤 95例 (38.5 % )、跌伤 5 4例 (2 1.9% )、踢伤及拳击伤 36例 (14 .6 % )。仅有腹内脏器伤 16 8例 ,AIS =3的 80例 (4 7.6 % )、=4的 32例 (19.0 % )、=5的 10例 (6 .0 % ) ;多发伤 79例 (32 .0 % ) ,ISS≥ 16的 2 7例 (34.2 % ) ,其中≥ 2 5的 8例 (10 .1% )。 结论 随着车辆和流动人员的逐年增加 ,交通伤、意外伤及斗殴等引起的腹部创伤也逐年增多。受伤人员以农民、学生、工人最多。受伤器官以实质脏器脾、肾、肝居前三位。AIS为重伤以上的大于半数。为减少腹部创?

Objective To discuss the injury spectrum and traumatic condition spectrum of trauma of abdominal organs in recent years. Methods Data of 247 cases with trauma on abdominal organ admitted in our hospital from 1999 to 2001 were analyzed in respects of injury spectrum, sex, age, vocation and injury causes of the cases with trauma of abdominal organs. Traumatic condition was evaluated by abridged injury score-injury severity score (AIS-ISS). Results There were 54 cases with trauma of abdominal organs in 1999, 72 in 2000 and 121 in 2001. Of all, 241 cases were cured but 6 died, with a fatality rate of 2.5%. The occurrence frequency of trauma of abdominal organs could be ranked in turn as follows: the spleen (43.2%), the kidney (18.8%), the liver (13.7%), the small intestine (6.5%),the bladder (4.8%), the pancreas (3.8%), the colon (3.8%), the stomach, the duodenum and the rectum. A total of 192 cases at age under 40 years accounted for 77.7% . Three injury causes ranked the first three places were traffic accident in 95 cases (38.5%), fall in 54 (21.9%), kick and boxing in 36 (14.6%), respectively. Of all, 168 cases had only intraabdominal injuries, of which 80 (47.6%) were with AIS=3, 32 (19.0%) with AIS=4 and 10 (6.0%) with AIS=5; and the other 79 cases (32.0%) were complicated by multiple trauma, with ISS ≥16 in 27 cases (34.2%) and ISS ≥25 in 8 (10.1%). Conclusions With the increase of vehicles and current personnel, the trauma of abdominal organs caused by traffic accident, accidental wound and conflict increases accordingly. People most apt to organ injuries are farmers, students and workers. Three organs ranked first three places are the spleen, the kidney and the liver. More than half cases are injured severely in accordance with AIS. To decrease trauma of abdominal organs, we must strengthen the education on traffic safety to raise their bewareness of injuries.