多发伤的诊断与救治模式研究进展

Research progress on diagnosis and treatment of multiple injuries

多发伤作为急诊常见的急危重症之一,发生率高且并发症致命。已成为当前创伤性死亡的主要原因之一,是45岁以下人群的首要致死原因。多发伤的诊断应根据其定义,具体到损伤部位、损伤性质的诊断、损伤并发症诊断及并存疾病诊断。对于多发伤患者伤情严重程度的评估,目前主要依靠简明损伤定级标准(abbreviated injury scale,AIS)和创伤严重程度评分(injury severity score,ISS)。随着对多发伤的认识不断加深,分科分诊救治模式、创伤一体化救治模式、以创伤中心为主导的多学科协助救治模式、由急诊科(含创伤中心)独立承担绝大多数多发伤手术及术后监护治疗的开展,为多发伤患者的救治争取了宝贵时间。

Multiple injuries are one of the most common critical illnesses in the emergency department, with a high incidence and fatal complications. It has become one of the leading causes of traumatic death and the leading cause of death in people under the age of 45. The diagnosis of multiple injuries should be based on its definition, specific to the location of the injury, the nature of the injury, the diagnosis of injury complications and the diagnosis of coexisting diseases. At present, the evaluation of the severity of multiple injuries mainly depends on the Abbreviated Injury Scale(AIS) and the Injury Severity Score(ISS). With the deepening of the understanding of multiple injuries, the mode of triage and treatment by department, the mode of integrated treatment of trauma, the mode of multidisciplinary assistance led by trauma center, and the independent responsibility of emergency department(including trauma center) for the development of operation and postoperative monitoring and treatment of most multiple injuries were carried out. Those has bought valuable time for the treatment of patients with multiple injuries. This paper reviews the research progress in the diagnosis and treatment of multiple injuries.