合并胸部损伤严重多发伤救治61例

Treatment of severe multiple trauma with thoracic injuries in 61 cases

目的探讨合并胸部损伤严重多发伤的临床特点及救治策略。方法回顾性分析广西医科大学第二附属医院急诊科收治的合并胸部损伤严重多发伤病例61例临床资料。分析受伤的原因及机制、临床表现、合并伤、并发症、治疗过程及预后。结果全组61例患者,损伤严重度评分(injury severity score, ISS)25-57分,平均(30.2±9.6)分;合并急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS) 16例,创伤性凝血病5例,脓毒症II例;住院死亡3例.自动出院4例,转康复治疗11例,治愈出院43例。结论合并胸部损伤严重多发伤以急、危重为特点,实行院前、院内整体化救治,早期重症康复,积极防治并发症,是获得良好预后的关键。

Objective To investigate the clinical features and treatment strategies of severe multiple trauma with thoracic injuries. Methods A retrospective analysis was performed on 61 cases of severe multiple trauma with thoracic injuries in our department. The causes and mechanisms of injuries, clinical manifestations, combined injuries, complications, treat me nt processes and prog nosis were analyzed. Results In all 61 patients, injury severity score (ISS) was 25-57 , with an average of 30.2±9.6;there were 16 cases of Acute Respiratory Distress Syndrome(ARDS), 5 cases of traumatic coagulopathy, and 11 cases of sepsis. Three cases were impatient death, 4 cases were discharged without cure, 11 cases were transferred to rehabilitation center, and 43 cases were cured. Conclusion The severe multiple trauma with thoracic injuries is characterized by acute and critical injuiy. It is the key to achieve a good prognosis by implementing integrative treatment in pre-hospital and in-hospital, early rehabilitation in ICU, aggressive prevention and treatment for complications.