Objective ：To investigate the early diagnosis and treatment of polytrauma patients with thoracic and/or abdominal injuries. Methods： The data of all polytrauma patients with thoracic and/or abdominal injuries durin...Objective ：To investigate the early diagnosis and treatment of polytrauma patients with thoracic and/or abdominal injuries. Methods： The data of all polytrauma patients with thoracic and/or abdominal injuries during the past 10 years were studied retrospectively. Results： In the present study, there were 1 540 polytrauma patients, accounting for 65.0% of all 2 368 trauma patients. Of these patients, 62.4% were in shock state on admission. The operative rates were 15.0% （181/1 206） and 79.9% （ 612/766 ） in patients with thoracic and abdominal injury （ P 〈 0.01 ）, 5.2 % （39/758） and 31.7% （142/448） in patients with blunt and penetrating chest trauma （P〈0.01）, and 72.4% （359/496） and 93.7 % （253/270） in patients with blunt and penetrating abdominal injuries （P〈0.01）, respectively. To deal with abdominal injury, angioembolization was performed in 43 cases, with 42 cured. The overall mortality rate was 6.2%. And in the blunt and penetrating subgroups, the mortalities were 7.9 % （75/950） and 3.6 % （21/590）, respectively （P〈0.01）. Most patients died from exsanguination. Conclusions： The first ＂golden hour＂ after trauma should be grasped, since the treatment in this hour can determine greatly whether the critically-injured victim could survive. Prompt diagnosis and proper treatment contribute more greatly to the survival of the victim than the severity of injury.展开更多
Objective: To explore the optimal treatment for craniocerebral trauma complicated with thoraco-abdominal injuries. Methods: A total of 2 165 cases of craniocerebral trauma complicated with thoraco-abdominal injuries a...Objective: To explore the optimal treatment for craniocerebral trauma complicated with thoraco-abdominal injuries. Methods: A total of 2 165 cases of craniocerebral trauma complicated with thoraco-abdominal injuries admitted to our hospital between July 1993 and June 2003 were retrospectively studied. Among them, 382 cases sustained severe craniocerebral trauma (in which 167 were complicated with shock), 733 thoracic injuries, 645 abdominal injuries and 787 thoraco-abdominal injuries. On admittance, 294 cases had developed shock. With the prime goal of saving life, respiratory and circulatory systems and encephalothilipsis were especially treated and monitored. Priority in management was directed to severe or open injures rather than to moderate or closed injures. For cases with cerebral hernia due to intracranial hematoma and severe shock due to blood loss, cerebral hernia and shock were treated concurrently. Results: After treatment, 2024 ( 93.49%) cases survived and the other 141 ( 6.51%) died. Among patients who had severe craniocerebral injury with shock and those without, 78 ( 46.71%) and 53 ( 24.56%) died, respectively. For patients who had underwent craniocerebral and thoraco-abdominal operations concurrently and those who had not, the death rates were 58.49%- 65.96% and 28.57% respectively, indicating a significant difference (P< 0.05). Conclusions: Treatment for hematoma hernia, shock and disturbed respiration is the key in the management of multiple trauma of craniocerebral, thoracic or abdominal injuries, especially when two or three conditions occurred simultaneously. Unless it is necessary, operations at two different parts at the same time is not recommended. It is preferred to start two concurrent operations at different time.展开更多
文摘Objective ：To investigate the early diagnosis and treatment of polytrauma patients with thoracic and/or abdominal injuries. Methods： The data of all polytrauma patients with thoracic and/or abdominal injuries during the past 10 years were studied retrospectively. Results： In the present study, there were 1 540 polytrauma patients, accounting for 65.0% of all 2 368 trauma patients. Of these patients, 62.4% were in shock state on admission. The operative rates were 15.0% （181/1 206） and 79.9% （ 612/766 ） in patients with thoracic and abdominal injury （ P 〈 0.01 ）, 5.2 % （39/758） and 31.7% （142/448） in patients with blunt and penetrating chest trauma （P〈0.01）, and 72.4% （359/496） and 93.7 % （253/270） in patients with blunt and penetrating abdominal injuries （P〈0.01）, respectively. To deal with abdominal injury, angioembolization was performed in 43 cases, with 42 cured. The overall mortality rate was 6.2%. And in the blunt and penetrating subgroups, the mortalities were 7.9 % （75/950） and 3.6 % （21/590）, respectively （P〈0.01）. Most patients died from exsanguination. Conclusions： The first ＂golden hour＂ after trauma should be grasped, since the treatment in this hour can determine greatly whether the critically-injured victim could survive. Prompt diagnosis and proper treatment contribute more greatly to the survival of the victim than the severity of injury.
文摘Objective: To explore the optimal treatment for craniocerebral trauma complicated with thoraco-abdominal injuries. Methods: A total of 2 165 cases of craniocerebral trauma complicated with thoraco-abdominal injuries admitted to our hospital between July 1993 and June 2003 were retrospectively studied. Among them, 382 cases sustained severe craniocerebral trauma (in which 167 were complicated with shock), 733 thoracic injuries, 645 abdominal injuries and 787 thoraco-abdominal injuries. On admittance, 294 cases had developed shock. With the prime goal of saving life, respiratory and circulatory systems and encephalothilipsis were especially treated and monitored. Priority in management was directed to severe or open injures rather than to moderate or closed injures. For cases with cerebral hernia due to intracranial hematoma and severe shock due to blood loss, cerebral hernia and shock were treated concurrently. Results: After treatment, 2024 ( 93.49%) cases survived and the other 141 ( 6.51%) died. Among patients who had severe craniocerebral injury with shock and those without, 78 ( 46.71%) and 53 ( 24.56%) died, respectively. For patients who had underwent craniocerebral and thoraco-abdominal operations concurrently and those who had not, the death rates were 58.49%- 65.96% and 28.57% respectively, indicating a significant difference (P< 0.05). Conclusions: Treatment for hematoma hernia, shock and disturbed respiration is the key in the management of multiple trauma of craniocerebral, thoracic or abdominal injuries, especially when two or three conditions occurred simultaneously. Unless it is necessary, operations at two different parts at the same time is not recommended. It is preferred to start two concurrent operations at different time.
