近年火车创伤中关节损伤变化的特点

Changes about joint injuries caused by train in recent years

目的探讨与分析快速列车所致火车创伤中关节损伤的变化特点。方法集1997～2000年火车提速后10214例火车创伤中1279例关节损伤病例,分析在特定条件下的致伤因素、损伤严重程度、损伤类型特点,经AIS-ISS评分证实与预后的关系。结果提速后关节损伤发生率由提速前33.54%上升到34.12%,死亡率由28.88%上升到30.33%,多关节离断伤由19.84%上升到34.13%,开放性关节损伤由31.71%上升到63.65%,关节离断伤的死亡率由21.19%上升到49.07%。结论火车创伤无疑是十分严重的损伤,多发伤率远高于其他损伤,治疗棘手,多器官功能不全综合征(MODS)是致死的主要因素。

Objective To analyze the recent changes in features of joint injury caused by the fast running railroad train. Methods 1279 joint injuries o f the 10214 cases of train injury after the speeding up of the railway services from 1997 to 2003 were analyzed to find out their particular causal conditions, the severity of the injury, and the classification of the injuries, the correlat ion between which and recovery was also tested by AIS-ISS grading. Results Afte r the speeding up of the railway services, the incidence of joint injuries rose from 33.54% to 34.12%,the mortality rose from 22.88% to 30.33%,the multipl e joint severances rose from 19.84% to 34.19%,the open joint injury rose from 31.71% to 63.15%,and the mortality caused by multiple joint severances rose from 21.19% to 49.07%. Conclusions The incidence of multiple traumas resulted from the train is much higher than those resulted from other causes. Multiple t raumas caused by train are very difficult to deal with. The multiple organ dysfu nction syndrome (MODS) is a main factor to cause the death.