多发性创伤急诊救治216例

Emergency Treatment on 216 Cases of Multiple Traumas

目的总结多发性创伤急诊救治经验。方法对2000年5月～2008年1月间216例多发性创伤急诊治疗过程进行分析,按Kirkpatrick创伤指数标准评定,平均分22分。按急诊抢救流程,常规化多学科专家合作,尽快建立静脉通道,生命监测,针对性进行各项检查,胸穿、腹穿等,抢救、诊断与治疗同时进行。诊断明确后立即急诊手术。结果静脉快速扩容216例,气道处理69例,辅助呼吸52例,胸腔闭式引流21例,颅脑手术39例,剖腹探查38例;剖胸检查25例;死于严重颅脑损伤9例,严重挤压伤7例,创伤性休克8例,失血性休克6例,脾破裂2例,骨盘骨折2例。结论多发性创伤病情复杂,救治难度大,而急诊救治直接影响伤情及预后,完善创伤急救体系是提高救治成功率关键。

Objective To summarize the experience of emergency treatment of multiple traumas. Methods The emergency treatment of 216 cases of multiple traumas from May 2000 to January, 2008 was analyzed and classified according to Kirkpatrick trauma index criteria, and the mean score was 22. According to the process of emergency treatment, routine cooperation was completed by multidiscipline specialists, venous transfusion and life supervision were established as soon as possible, proper examinations thoracic puncture and abdominal puncture were done, rescue, diagnosis and treatment were performed at the same time, and confirmed diagnosis was followed by emergency surgeD＇ immediately. Results Rapid venous transfusion was done in 216 cases, airway treatment in 69 cases, assisted respiration in 52 cases, closed thoracic drainage in 21 cases, craniocerebral operation in 39 cases, exploratory laparotomy in 38 cases, exploratory thoracotomy in 25 cases; and among which 9 patients died from severe cranial injury, 7 patients severe crush injury, 8 patients traumatic shock, 6 patients hemorrhagic shock, 2 patients splenic rupture, 2 patients pelvic fracture. Conclusion The condition of multiple traumas were so complicated that the treatment was very difficult, and the emergency treatment directly affected the traumatic condition and prognosis, therefore, to perfect the first-aid system was the key to improve the success rate of treatment.