老年严重创伤患者救治分析

Analysis of remedy on senile severe trauma

目的对广州医院第二附属医院对老年人严重创伤病例进行方法与目的回顾性分析,以便提高对老年人严重创伤的急救水平。方法从急诊外科1997年10月至2004年10月收治的急诊危重抢救中筛选出需抢救的老年人严重创伤102例进行回顾性分析。结果伤员构成:男性76例,女性26例,男:女为2.9∶1;年龄平均69.2岁(60～83岁);创伤评分(TS)(14.3±2.6),格拉斯哥昏迷评分(GCS) (11.8±3.1),创伤严重程度评分(ISS) (24.5±10.7)。多发伤61例(59.8%),病因:交通伤占45例(43.3%),跌倒23例(22.5%),坠落伤19例(18.6%),重物砸伤8例(7.8%),其他损伤8例(7.8%)。休克65例。实施确定性抢救手术68例,急诊治疗至科室手术时间:抢救脱险组(58±19)min,死亡组(111±34)min,两组差异具有统计学意义(P<0.01)。结论交通伤、跌倒、坠落伤是城市老年人严重创伤的主要因素;早期实施确定性抢救手术,可以有效地提高城市老年严重创伤的抢救效果。

Objective To study senile severe trauma patients admitted to Emergency Surgical Department of the second affiliated hospital of Guangzhou Medical college from October 1997 to October 2004, to investigate constructive suggestions of emergency treatment for urban senile trauma. Method Retrospective analysis on 102 senile severe trauma patients screened out from trauma patients admitted to the Emergency Surgical Department was CalTiedout. Results There were 76 male and 26 female patients, the ratio of male to female was 2 . 9 ： 1 , mean age was 69.2 years old （ range 60- 83 years）, the mean trauma score （TS） was （ 14.5 ± 2.6）, the mean Glasgo Coma Score （GCS） was （11.8±3.1）, the mean Injury Severity Score （ISS） was （24.5±10.7）, there were 61 patients of multiple injuries, transportation accident 45 patients （43.3%） , tumbling injury 23 case （22.5%）, falling injury 19 patients （18.6%）, shock 65 patients. Definitive rescue surgery was carried out in 68 patients. The time from emergency treatment to operation departments was （58 ± 19） minutes for the survival patients and （111 ± 34） minutes for those died, there was significant difference between the two groups （ P 〈 0.01 ）. Conclusions Transportation accident, tumbling injury and falling injury were the major causes of urban senile severe trauma, early definitive rescue surgery , can effectively improve the result of urban senile severe trauma therapy.