336例多发伤救治中死亡病例特点分析

Analysis on characteristics of death cases in treating multiple injury

目的探讨多发伤救治中死亡病例的特点。方法回顾2012-01至2013-12江苏大学附属人民医院急诊科收治的多发伤336例临床资料及救治结果,分析多发伤的创伤部位数目及ISS评分与死亡之间的关系。结果全组治愈296例(88.10%),死亡40例(11.90%);创伤部位计数由多到少前四位依次是四肢(71.43%),头部(63.69%),腹部(54.76%),胸部(53.57%);四个部位或以上损伤的伤者病死率最高50%(28例),显著高于两个或三个部位损伤分组的病死率(4.55%和4.17%);随着ISS评分的增高,死亡比例逐渐升高。结论对于多个部位创伤(≥4)伤者的救治依然是临床多发伤救治的难点;应加强对多发伤危重伤者救治的研究。

Objective To explore characteristics of death cases in the treatment of multiple injury. Methods Review the clinical data and outcomes of 336 cases of multiple injury during 2012-01 and 2013-12 that treated in affiliated people hospital of Jiangsu university, and analyze the relationship between amount of wounded part, ISS scores and death. Results 296 cases were cured （88.10%） and 40 cases were dead （ 11.90% ）. Order of wounded part from most to least were limbs（71.43% ） , head（63.69% ） , abdomen（54.76% ） , chest（53.57% ） ; Death rate among patients who injuried 4 plus parts was highest（28eases, 50% ） , and it was outstandingly exceed that injuried 2 or 3 body parts （4.55% and 4.17% , separately） ; with the raisintg of ISS scores, death rate increased gradually. Conclusions Treatment for patients injured more than 4 parts is still the difficult points in muhiple injuries ; study on treatment of critical patients with multiple injury should be strengthened.