急诊外科创伤患者病死的危险因素及急救措施

Risk factors of mortality in patients with trauma in emergency surgery and first aid measures

目的探讨分析引起急诊外科创伤患者病死因素及相关急救措施。方法对本院急诊外科2012年11月至2015年10月收治的156例创伤死亡患者进行回顾分析,统计患者资料,利用Logistic分析对可能引起创伤患者死亡的因素进行研究分析。结果 20岁以上的创伤死亡患者占75.64%,为急诊创伤死亡主要人群。91例患者有多处创伤,多发率为58.33%,创伤集中部位主要为腹部、胸部及头部,101例患者院前抢救无效,院前死亡率占64.74%。从致伤原因分析,以交通事故、高空坠落创伤致死为主,分占60.26%、25.00%,Logistic多因素分析显示,创伤患者年龄、现场急救、机械通气及GCS评分、ISS评分是引起创伤患者病死的主要危险因素。结论医疗机构应该建立专业的急救团队及系统、迅速的应急机制,强化院前急救与院内急诊的急救水平,保证创伤患者可以第一时间得到救治,以提高急救成功率。

Objective To investigate and analyze the factors that cause the death of trauma patients in emergency surgery and related emergency measures. Methods Retrospective analysis of 156 cases of trauma deaths in our hospital from October 2015 to November 2012 in our hospital, statistical data of patients, using Logistic analysis to analyze the factors that may cause the death of trauma patients. Results Trauma deaths accounted for 20 of patients over the age of 75.64%, and the major population of emergency trauma deaths. 91 cases of patients with multiple trauma, multiple rate was 58.33%, the trauma focused on the main parts of the abdomen, chest and head, 101 cases of patients with pre hospital res- cue is invalid, the pre hospital mortality rate was 64.74%. Analysis of the causes of injury, traffic accidents, injuries to the upper air crash deaths, accounting for 60.26%, 25%, Logistic multi factor analysis showed that the age of trauma patients, on-site first aid, mechanical ventilation and GCS score, ISS score is the main risk factors of trauma patients died. Conclusion Medical institutions should establish a professional emergency team as well as the system, rapid emergency response mechanism, strengthen pre hospital emergency treatment and hospital emergency level, to ensure that the trauma patients can be treated for the first time, to improve the success rate of first aid.