创伤严重度综合评定计分法在创伤急救中的应用

Clinical application of combined scoring in emergency of traumatic patients

目的 探讨总结创伤严重度综合评定计分法在创伤急救中的应用 ,以达到快速救治、快速分流 ,改变既往轻、中、重创伤患者集中救治的做法。方法 结合本创伤中心创伤患者的伤情严重度 ,采用国内吴恒义等设计的创伤严重度综合评定计分法 ,即“吴氏”计分法 (包括创伤、生理参数和附加分 )对救治的1 1 2 0例创伤患者的创伤严重度评分法进行计分。 1 5～ 2 4分为重度患者 (81 2例 ) ,2 5～ 34分为危重度患者(2 34例 ) ,≥ 35分为极危重度患者 (74例 )。结果 通过综合评定计分法 ,对轻伤员集中处置 ,重伤员优先抢救 ,并总结出创伤患者救治成功和导致死亡的重要原因。创伤病人计分值越高 ,则病情越重 ,抢救成功率越低 ,死亡率较高。结论 创伤医院使用创伤严重度评分法的基本原则是比较创伤患者伤情严重性 ,以正确诊断并采取快速有效的救治措施 ,降低创伤患者的死亡率和伤残率 ;有利于判断创伤患者的预后 。

Objective To bond the combined scoring for trauma in our traumatic center to treat mildly wounded patient concentratedly and to rescue severe patient precedingly, to achieve cure and diffluence quickly,to alter the concentrated treatment of slight,moderate,and severe traumatic patient in the past.Methods To adopt the combined scoring for trauma (including the trauma itself,physiological index,and additional index) in 1120 traumatic patients.The score of 15 to 24 points are severe trauma (812 cases).The score of 25 to 34 points are critical risk trauma (234 cases).The total scores exceeding 35 points are highly critical risk trauma (74 cases).Results The trauma score was highly correlated to the prognosis, and high score usually carried a poor outcome after trauma.Conclusion The basic principles of the trauma score method have many advantages in traumatic hospital,including the comparison of the severity of trauma patient,the accurate diagnosis and prompt treatment and decrease of the mortality and disability of trauma patient.It is advantageous to judge the prognosis and to guide the emergency treatment of traumatic patient.