急诊救治创伤患者死亡发生危险因素与急诊救治对策

Risk factors of death in patients with trauma in emergency treatment and emergency treatment countermeasures

目的:探讨急诊救治创伤患者死亡的危险因素及急诊救治对策。方法:回顾性分析2014年5月至2017年5月我院急诊救治的210例创伤患者的临床资料,其中死亡病例为60例,收集并比较所有患者的性别、年龄、创伤原因、机械通气、现场急救、格拉斯哥昏迷指数、创伤严重度评分等资料。结果:单因素分析显示,死亡患者与存活患者的年龄、现场急救、GCS评分、ISS评分之间比较差异有统计学意义(P<0.05)。多因素Logistic分析显示,年龄≥50岁、现场急救不规范、GCS评分≥7分、ISS评分≥25分是急诊救治创伤患者死亡的独立危险因素(P<0.05)。结论:急诊救治创伤患者死亡的独立危险因素为年龄≥50岁、现场急救不规范、GCS评分≥7分、ISS评分≥25分,可针对年龄较大、GCS与ISS评分较高的患者制定相应的干预措施,改善救治的成功率。

Objective： To explore the risk factors of death in patients with trauma in emergency treatment and related emergency treatment countermeasures. Methods： From May 2014 to May 2017,the clinical data of210 trauma patients in our hospital were analyzed retrospectively,including 60 cases of death. Sex,age,traumatic cause,mechanical ventilation,field first aid,Glasgow coma index,and trauma severity score were collected and compared among all patients. Results： Univariate analysis showed that there was a statistically significant difference in the age,field first aid,GCS score,and ISS score between the patients who died and those who survived（ P〈0.05）. Logistic multivariate analysis showed that age ≥ 50 years,first aid not standardized,GCS score ≥ 7 points,ISS score ≥ 25 points were independent risk factors of death in emergency treatment of trauma patients（ P〈0. 05）. Conclusion： The independent risk factors of death in trauma patients in emergency treatment are age ≥ 50 years,first aid not standardized,GCS score≥ 7 points,ISS score ≥ 25 points. And for patients with older age,higher GCS and ISS scores,weshould develop appropriate interventions to improve the success rate of emergency treatment.