Comprehensive Level One Trauma Center Could Lower In-hospital Mortality of Severe Trauma in China

Trauma is a major health and social problem in the US and China, It constitutes the main cause of death in people aged 45 or under in both countries112]. There is clear evidence from clinical studies that a large percentage of these deaths are needless and preventable if better treatment and prevention programs are available12-3].

Outcome predictors for severely brain-injured patients directly admitted or transferred from emergency departments to a trauma center

Dear editor,After sustaining severe traumatic brain injury(TBI),patients frequently require invasive mechanical ventilation(MV).However,up to 26%of patients require tracheostomy due to failure to wean from the ventilator.[1]The decision of when to perform tracheostomy is important as it balances the risk between avoiding prolonged MV and avoiding risk of tracheostomy.Early predictors for tracheostomy,i.e.,clinical factors when patients first present to an Emergency Department after trauma or when patient fi rst arrive at a regional trauma center,can help clinicians’medical decision-making process.

Changes and significance of serum troponin in trauma patients: A retrospective study in a level I trauma center

BACKGROUND: Elevated troponin I(TnI) is common among trauma patients. TnI is an indicator of myocardial injury, but clinical diagnosis of blunt cardiac injury cannot be based solely on an increase in TnI. Therefore, this study aims to explore the changes and clinical significance of serum TnI in trauma patients. METHODS: The clinical data of consecutive trauma patients admitted to our trauma center between July 1, 2017 and July 31, 2020 were retrospectively analyzed. According to TnI levels within 24 hours of admission, patients were divided into the elevated and normal TnI groups. According to the TnI levels after 7 days of admission, a graph depicting a change in trend was drawn and then analyzed whether TnI was related to in-hospital mortality. RESULTS: A total of 166 patients(69 and 97 cases with elevated and normal TnI, respectively) were included in this study. The average hospital stay, intensive care time, mechanical ventilation time, and in-hospital mortality were higher in the elevated TnI group than in the normal TnI group(P<0.05). The TnI level of trauma patients gradually increased after admission and peaked at 48 hours(7.804±1.537 ng/mL). Subsequently, it decreased, and then recovered to normal within 7 days. However, 13 patients did not recover. Logistic regression analysis revealed that abnormal TnI at 7 days was independently related to in-hospital mortality. CONCLUSIONS: Trauma patients with elevated TnI levels may have a worse prognosis. Monitoring the changes in serum TnI is important, which can reflect the prognosis better than the TnI measured immediately after admission.

Incidence and pattern of traumatic spine injury in a single level I trauma center of southern Iran

Purpose:Spine injury is one of the leading causes of death and mortality worldwide.The objective of this study was to determine the incidence,pattern and outcome of trauma patients with spine injury referred to the largest trauma center in southern Iran during the last 3 years.Methods:This is a cross-sectional study conducted between March 2018 and June 2021 in the largest trauma center in the southern Iran.The data collection form included the age,sex,injury location(cervical,thoracic,and lumbar),cause of injury(traffic accidents,falls,and assaults),length of hospital stay,injured segment of spine injury,severity of injury,and outcome.Statistical analyzes were performed using SPSS software version 24.Results:Totally 776 cases of spine injury were identified.The spine injury rate was 17.0%,and the mortality rate was 15.5%.Cervical spine injury(20.4%)more often occulted in motorcycle accident,and thoracic spine injury(20.1%)occulted in falls.The highest and lowest rates of spine injurys were related to lumbar spine injury(30.2%)and cervical spine injury(21.5%),respectively.There was a statistically significant relationship between the mechanism of injury and the location of spine injury(p<0.001).And patients with lumbar spine injury had the highest mortality rate(16.7%).Injury severity score(OR=1.041,p<0.001)and length of stay(OR=1.018,p<0.001)were strong predictors of mortality in trauma patients with spine injury.Conclusion:The results of the study showed that the incidence of traumatic spine injury rate was approximately 17.0%in southern of Iran.Road traffic injury and falls are the common mechanism of injury to spine.It is important to improve the safety of roads,and passengers,as well as work envi-ronment,and improve the quality of cars.Also,paying attention to the pattern of spine injury may assist to prevent the missing diagnosis of spine injury in multiple trauma patients.

Approach to traumatic cardiac arrest in the emergency department: a narrative literature review for emergency providers

BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare system.Although there have been advances in treatment modalities,survival rates for TCA patients remain low.This narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating TCA.METHODS:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,2022.The search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English language.Following the search,943 articles were retrieved,and two independent reviewers conducted a screening process.RESULTS:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable rhythm.There were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital epinephrine.Emergency thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt trauma.Resuscitative endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic shock.When implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality rates.Veno-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,respectively.In the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ECLS.CONCLUSION:TCA remains a signifi cant challenge for emergency medical services due to its high morbidity and mortality rates.Pre-and intra-arrest prognostic factors can help identify patients who are likely to benefit from aggressive and resource-intensive resuscitation measures.Further research is needed to enhance guidelines for the clinical use of established and emerging therapeutic approaches that can help optimize treatment effi cacy and ameliorate survival outcomes.

Trauma care construction under the guidance of county-level trauma centers

严重损伤在治疗有复杂状况，包含的多重机关，有限辅助考试，和困难的特征。大多数损伤病人被送到主要医院接受治疗。但是管理能容易导致的分开的纪律的传统的模式推迟了治疗，错过或冤枉诊断和高残疾，它在严重损伤病人引起高死亡。因此，如果主要医院，特别县级的医院(通常在一个县的行政区域以内的最高的综合医院) ，能建立一个科学、全面的损伤照顾系统，在这个区域的损伤营救的成功率能极大地被改进。在 2013 年 3 月 1 日，浙江省的 Tiantai 民族医院，中国建立了一个损伤照顾中心，它综合医院前和在里面医院损伤治疗过程，并且完成了好经济、社会的好处。到 2017 年 3 月 1 日为止， 1265 个严重损伤病人(损害严厉分数 > 16 ) 在这个损伤中心被对待。营救成功率到达了 95% ，推迟或错过的诊断率是不到 5% 。完全，有不稳定的 hemodynamics 的骨盆的破裂的 86 个严重盒子被对待，并且成功率是 92% 。在里面医院紧急情况营救反应时间是不到 3 ? 到外科的从明确的诊断的 min，和时间在 35 以内 ? min。

A study of mortal让y risk factors among trauma referrals to trauma center, Shiraz, Iran, 2017

Purpose: Trauma is well known as one of the main causes of death and disability throughout the world. Identifying the risk factors for mortality in trauma patients can significantly improve the quality of care and patient outcomes, as well as reducing mortality rates. Methods:【n this retrospective cohort study, systematic randomization was used to select 849 patients referred to the main trauma center of south of Iran during a period of six months (February 2017-July 2017);the *patients case files were evaluated in terms of demographic information, pre- and post-accident conditions, clinical conditions at the time of admission and finally, accident outcomes. A logistic regression model was used to analyze the role of factors affecting mortality among subjects. Results: Among subjects, 60.4% were in the age-group of 15-39 years. There was a 10.4% mortality rate among patients and motor-vehicle accide nts were the most comm on mecha nism of injury (66.7%). Aging led to in creased risk of fatality in this study. For each urHt increase in Glasgow coma scale (GCS), risk of death decreased by about 40%(odds ratio (OR)= 0.63, 95% confidence interval (C/): 0.59—0.67). For each unit increase in injury severe score (ISS), risk of death increased by 10%(OR = 1.11%, 95% Cl: 1.08-1.14) and for each unit in crease in trauma revised injury severity score (TRISS), there was 18% decrease in the risk of fatality (OR = 0.82, 95% CI: 0.71-0.88). Conclusion: The most common cause of trauma and the most common cause of death from trauma was traffic accidents. It was also found that an increase in the ISS index increases the risk of death in trauma patients, but the increase in GCS, revised trauma score (RTS) and TRISS indices reduces the risk of death in trauma patients. The TRISS indicator is better predictor of traumatic death than other indicators.

Epidemiology of livestock-related injuries in a major trauma center in Kashan, Iran

ObjectiveLivestock 相关的损害是在进入医院的病人引起病态和死亡的重要因素之一。这些病人的治疗仍然是在护理系统的一个主要问题。当前的学习的目的是从 2006 在伊朗在一个主要损伤中心估计家畜相关的损害的传染病学到 2011MethodsIn 未来的研究，连续地进入损伤的有 live-stock-related 损害的病人在 Kashan 集中，在 2006 和 2011 之间的伊朗被评估。数据收集了事故，损坏机关，教育水平，运输和结果的包括的 patient&rsquo;s 人口分布，地方和自然。数据被表示为 mean&#xA0； &plusmn;&#xA0； 129 个病人全部的标准 deviation.ResultsA 在这研究被包括，为 0.3% 所有损伤承认(40 273 个盒子) 的财务。吝啬的年龄是(55.27 &#xA0； &plusmn;&#xA0； 14.45 ) 年。男人多于女人被影响四次。从家畜掉下来是在所有组的损伤的主要机制。上面、更低的极限最经常被伤害(n&#xA0； =&#xA0； 72 ) ，用头，颈和脊骨列在后面(n&#xA0； =&#xA0； 33 为各个) 。有一死亡，从家畜相关的损害导致这 study.ConclusionDespite 低发生，家畜相关的损害能损坏人的身体和因此适当的训练节目的主要机关在家增加安全了解并且室外是很重要的。

Intranasal nerve growth factor for prevention and recovery of the outcomes of traumatic brain injury

Traumatic brain injury is one of the main causes of mortality and disability worldwide.Traumatic brain injury is characterized by a primary injury directly induced by the impact,which progresses into a secondary injury that leads to cellular and metabolic damages,starting in the first few hours and days after primary mechanical injury.To date,traumatic brain injury is not targetable by therapies aimed at preventing and/or limiting the outcomes of secondary damage but only by palliative therapies.Nerve growth factor is a neurotrophin targeting neuronal and non-neuronal cells,potentially useful in preventing/limiting the outcomes of secondary damage in traumatic brain injury.This potential has further increased in the last two decades since the possibility of reaching neurotrophin targets in the brain through its intranasal delivery has been exploited.Indeed,molecules intranasally delivered to the brain parenchyma may easily bypass the blood-brain barrier and reach their therapeutic targets in the brain,with favorable kinetics,dynamics,and safety profile.In the first part of this review,we aimed to report the traumatic brain injury-induced dysfunctional mechanisms that may benefit from nerve growth factor treatment.In the second part,we then exposed the experimental evidence relating to the action of nerve growth factor(both in vitro and in vivo,after administration routes other than intranasal)on some of these mechanisms.In the last part of the work,we,therefore,discussed the few manuscripts that analyze the effects of treatment with nerve growth factor,intranasally delivered to the brain parenchyma,on the outcomes of traumatic brain injury.

以高水平急诊大平台建设推动急诊创伤医学的高质量发展

我国现代急诊医学起步虽晚,但近年来发展较快。在急诊3.0时代,急诊科的核心价值观是以需求、问题、危重度、“时间线”和“时间窗”为导向,以学科建设为中心,以“五大中心”为抓手构建院前院内一体化高水平急诊大平台。努力整合高水平救治平台、高水平技术能力、高素质人才队伍、高层次人才培养能力、高水平管理能力和高效率运行能力,进一步推动急诊创伤医学和公立医院的高质量发展,更好地满足人民日益增长的急诊医疗卫生服务需求。

序贯性血液净化机治疗中毒所致的多器官功能障碍的临床效果及安全性评估

目的:研究序贯性血液净化机治疗中毒所致的多器官功能障碍的临床效果及安全性。方法:选取2020年5月至2022年2月新疆医科大学第一附属医院收治的110例中毒所致多器官功能障碍综合征(MODS)患者,采用随机数表法将其分为序贯性血液净化组和单种血液净化组,每组55例。对比两组患者在不同血液净化治疗下营养代谢指标、肠道屏障功能指标、急性生理与慢性健康量表(APACHEⅡ)评分、MODS早期预测评分系统及重症监护室(ICU)住院时间,同时记录不同血液净化治疗期间的并发症发生率。结果:两组治疗7d后,序贯性血液净化组患者的血红蛋白(Hb)、白蛋白(ALB)、胱抑素A(PAB)以及总胆固醇(TC)高于单种血液净化组,谷丙转氨酶(ALT)和甘油三酯(TG)均低于单种血液净化组,差异有统计学意义(t=4.454、4.474、13.22、2.035、51.358、2.195,P<0.05)。两组治疗7d后,钾离子(K+)及钠离子(Na+)差异无统计学意义(P>0.05)。序贯性血液净化组治疗7d后谷氨酸水平及谷氨酰胺水平高于单种血液净化组,尿乳果糖/甘露醇(L/M)比值低于单种血液净化组,差异有统计学意义(t=32.83、3.435、4.132,P<0.05)。序贯性血液净化组治疗7d后APACHEⅡ评分、MODS评分低于单种血液净化组,ICU住院时间短于单种血液净化组,差异有统计学意义(t=4.438、4.481、7.421,P<0.05),血液净化治疗并发症发生率低于单种血液净化组,差异有统计学意义(χ^(2)=5.238,P<0.05)。结论:序贯性血液净化治疗相比于单种血液净化治疗,在中毒所致的多器官功能障碍综合征治疗中可更好的促进调节机体营养代谢指标,改善肠道屏障功能,康复效果更好,并发症发生率较低,同时缩短了ICU住院时间。

创伤中心医疗质量控制指标专家共识

创伤是全世界的重大公共卫生问题,是45岁以下人群第1位的死亡原因,也是我国城乡居民的五大死因之一。创伤救治体系的建设是提高患者生存率的关键,完善的创伤救治体系能够确保患者迅速得到专业医疗救助,创伤中心的建设能够改善创伤救治效果。目前,我国不同地区的创伤救治质量大不相同,对创伤救治的医疗过程采用全面质量管理和对创伤的现场救援、院前急救和院内治疗进行标准化控制,是提高创伤救治能力水平和创伤患者生存率的重要措施。医疗质量控制指标作为医疗全面质量管理的关键因素,其可以引领创伤中心发展的方向。为进一步加强创伤救治的医疗质量管理,规范临床诊疗行为,促进医疗服务的标准化、同质化,国家创伤医学中心医疗质量控制专业委员会结合国内创伤救治现状,对国家卫生健康委员会2018年发布的《关于进一步提升创伤救治能力的通知》中创伤中心医疗质量的16项控制指标进行了细化和更新,制定了新版19项质量控制指标,包含名称、定义、计算方式、意义、质量控制对象等,供各级创伤中心在医疗质量管理工作中使用,为创伤中心的质量控制工作提供可循路径。实施这些质量控制指标能够引导医疗机构对创伤救治的各个环节进行严格监控和评估,并及时解决存在的问题;同时,这些指标可以提升机构内部协作效率,加强相关科室之间的沟通和协作,从而提高创伤救治的效率与水平。

重力引导螺旋型鼻肠管空肠置管操作流程及教学歌诀

为了提高鼻肠管床旁定位的有效性和空肠置管的成功率,根据经典文献,结合自己的操作实践,编写了一个重力引导螺旋型鼻肠管空肠置管的操作流程及教学歌决。歌决内容:肠内营养寓胜算,空肠置管莫等闲。方法多样各神通,大力推广路漫长。半坐吞咽进食管,回抽自如识胃腔。右卧轻张过幽门,左卧低阻到空肠。胃内折返何征象?导管反弹最先见,充气受阻“折返征”,染色定位胜影像。真空试验最敏感,酸碱序变特异强,美蓝试验神答问,三法联用共导航。腹部平片金标准,超声时代仍可参。立体影像整体观,更有断层解疑难。此教学歌决以简明扼要、易于记忆的形式,成为临床手把手鼻肠管置管教学的有力工具。

血清miR-31在主动脉狭窄致心肌肥厚患者中的作用价值

目的探究血清microRNA-31(miR-31)在主动脉狭窄致心肌肥厚患者中的作用。方法选取2020年1月至2020年10月就诊于新疆医科大学第一附属医院的主动脉狭窄致心肌肥厚患者150例为观察组,并选取同期健康志愿者150例为对照组,比较两组患者miR-31、舒张末期左心室后壁厚度(LVPWTd)、室间隔舒张末期厚度(IVSTd)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)和左心室重量指数(LVMI)。同时对150例主动脉狭窄致心肌肥厚患者进行随访3年,观察其是否发生不良心血管事件,分析miR-31对不良心血管事件的预测价值。结果与对照组比较,观察组miR-31显著增加(1.25±0.26 vs.0.71±0.23,P<0.001)。血清miR-31与主动脉狭窄致心肌肥厚患者LVPWTd、IVSTd、LVEDD、LVMI均呈显著正相关(r=0.372、0.401、0.362和0.452,P<0.05),而与LVEF呈显著负相关(r=-0.317,P=0.010)。对150例主动脉狭窄致心肌肥厚患者随访3年发现,与未发生不良心血管事件的患者相比,发生不良心血管事件的患者血清miR-31显著增加(1.44±0.17 vs.1.21±0.26,P<0.001)。血清miR-31对主动脉狭窄致心肌肥厚患者不良心血管事件具有较好的预测价值,曲线下面积0.752(95%CI:0.668~0.837,P<0.001)。结论血清miR-31在主动脉狭窄致心肌肥厚患者中可能具有重要潜力,是主动脉狭窄致心肌肥厚的潜在生物学指标。

高级实践护士角色能力评价研究进展

目前国际上较认可的高级实践护士(APN)角色能力评价工具有APN评估工具包、Scarpa的APN角色评估工具、Strong高级实践角色描述工具(M-Strong APRD)和胜任力角色评价工具(PEAC Tool)等。角色能力评价指标包括患者质量安全指标、护理专业发展指标、多学科合作指标和对医疗保健系统的影响指标等。本文旨在总结国际上APN角色能力评价的方法,为我国APN角色能力评价提供理论依据。在临床应用时,可将角色能力评价工具和角色能力评价指标相结合,综合应用多维度的评价方式进行全面地评价,以更好地明确APN的独立贡献。

北京冬奥会雪车雪橇项目医疗急救的保障

目的:对国家雪车雪橇中心的雪车、雪橇、钢架雪车赛道医疗保障情况进行分析及总结,为今后赛事举办及群众冰雪运动的医疗保障工作提供经验。方法:回顾性分析参加2021年10—11月雪车、雪橇、钢架雪车国际训练周和世界杯(以下简称“国际训练周”),及2022年2月北京冬奥会雪车、雪橇、钢架雪车项目(以下简称“北京冬奥会”)的运动员受伤、救治情况,参考和借鉴《冬季雪上运动项目医疗保障标准》制定具体的分类标准分析受伤部位、受伤类型、事故发生点位等。结果:参加国际训练周和北京冬奥会总计743名运动员,比赛期间共发生翻车、翻撬、碰撞事故58次,其中有28次(运动员28例)出现了运动员受伤,占事故总数的48.3%,占运动员总数3.8%,其中男性9例(32.1%),女性19例(67.9%),平均年龄(26.3±4.7)岁。28例受伤运动员中20例(71.4%)为Ⅰ类伤,在现场得到了救治处理,8例(28.6%)伤情较重的,其中Ⅱ类伤(7例)、Ⅲ类伤(1例)转诊至定点医院进行进一步处理。28例受伤运动员中有3例(10.7%)出现了多发损伤,其中2例为2部位受伤,1例为3部位受伤,最常见的受伤部位为脚踝及脚趾(10/32,31.3%)。28例受伤运动员中有1例(3.6%)同时出现了2种受伤类型,最常见的受伤类型为关节和(或)韧带损伤(11/29,37.9%)。赛道最容易发生事故的点位为第9弯道(18/58,31.0%)。结论:通过对医疗保障工作的分析和总结,能够更好地为今后我国开展雪车、雪橇、钢架雪车运动提供经验和参考,使国家雪车雪橇中心真正成为可持续发展的奥运资产。

严重创伤患者损伤严重度评分的一致性

目的:通过3名临床医师对严重创伤患者的损伤严重度评分(injury severity score,ISS)进行一致性分析,确定该评分对于临床严重创伤患者病情评估的准确性及对医疗资源分配的指导价值。方法:选取北京大学人民医院2020年9月至2021年12月收治的100例重伤或严重创伤患者(ISS≥16分),将患者入院后的一般信息(性别、年龄)、生命体征、体格检查、影像学、实验室检查等数据分别交由3名创伤外科专业临床医师作为评价者进行回顾性诊断,并进行ISS评分,使用SPSS 22.0软件进行相关统计学分析,对各项数据的观察值进行描述,并使用Fleiss kappa检验对3名医师之间ISS评分可信度进行一致性分析。结果:通过3名评价者对100例严重创伤患者的ISS评分进行一致性分析得出总Fleiss kappa值为0.581,整体一致性为中等。根据ISS评分计算规则对不同分值进行一致性分析,其中单部位严重创伤简明损伤评分(abbreviated injury scale,AIS)为4分或5分、ISS评分为16或25分的患者,3名评价者间Fleiss kappa值分别为0.756及0.712,有较高的一致性;各部位AIS均≥4分,即ISS总评分≥41分的严重创伤患者,3名评价者间Fleiss kappa值均≥0.8,有高度的一致性。结论:根据3名评价者对于严重创伤患者的ISS评分一致性分析可知,当救治或转运ISS≥16分的严重创伤患者时,该评分在用于科室间沟通或医院间转运时存在一定的准确性误差,不同评价者对于同一损伤的评分一致性中等,可能造成对于病情严重程度的误判以及医疗资源分配的不当,但对于单部位或多部位AIS评分≥4分的创伤患者,ISS评分在不同评价者间高度一致,可准确表明及传达患者病情严重程度。

神经元来源细胞外囊泡促进神经干细胞的神经生成

背景:已有研究表明,神经干细胞能够分化为神经元、星形胶质细胞和少突胶质细胞等。间充质干细胞来源细胞外囊泡被证实能够透过血脑屏障到达中枢神经损伤部位,促进神经修复。然而,神经元来源细胞外囊泡是否促进神经干细胞向有益于神经生成的方向分化,帮助神经修复,还不是很明确。目的:探究神经元来源细胞外囊泡是否有利于神经干细胞向神经生成的方向分化。方法:用胰酶消化法从新生SD大鼠大脑皮质中提取神经元和神经干细胞。收集培养神经元的细胞上清,提取神经元来源细胞外囊泡。将培养10 d的神经干细胞与神经元来源细胞外囊泡或PBS共培养7 d,采用免疫印迹、免疫荧光和RT-qPCR技术分别检测神经元、神经干细胞、少突胶质细胞和星形胶质细胞特异性标志蛋白的表达。结果与结论:神经干细胞与神经元来源细胞外囊泡共培养后,高表达神经元特异性蛋白β3微管蛋白、神经丝蛋白200和少突胶质细胞特异性蛋白髓鞘碱性蛋白,低表达星形胶质细胞特异性标志蛋白胶质纤维酸性蛋白。这些结果说明,神经元来源细胞外囊泡能够促进神经干细胞向神经元和少突胶质细胞分化,抑制其向星形胶质细胞分化。

快速康复技术配合损伤控制外科技术在多发伤患者中的运用效果及影响因素分析

目的分析快速康复技术配合损伤控制在多发伤患者康复中的临床效果及其并发症发生情况,并探讨影响并发症发生的因素。方法收集昆明医科大学附属红河医院2020年10月至2022年11月间的108例多发伤患者临床资料,分为A组(55例)和B组(53例)。A组采用快速康复措施+损伤控制,B组采用常规康复措施+损伤控制。比较2组临床疗效、并发症发生情况及相关影响因素。结果A组在凝血功能、乳酸、体温恢复时间及术中出血量方面明显优于B组(P<0.05),而手术时间则较长(P<0.05)。A组术后ISS评分及Mb、CK、HMGB1水平均低于B组(P<0.05)。A组并发症发生率(7例)低于B组(20例)(P<0.05)。Logistic回归分析显示,治疗康复措施是影响术后并发症的主要因素。结论快速康复技术配合损伤控制治疗多发伤患者具有较好的临床效果,可明显降低术后并发症发生率,其中良好的康复治疗方式是减少并发症的关键。