ICU严重交通伤患者漏诊的原因分析  

Missed Injuries in Patients with Severe Traffic Trauma

作　　者：冒山林[1] 徐波[2] 王洪飞[2] 刘励军[2] 

机构地区：[1]复旦大学上海第五人民医院重症医学科,上海200240 [2]苏州大学第二附属医院急诊重症医学科,江苏苏州215004

出　　处：《中国血液流变学杂志》2011年第2期273-275,291,共4页Chinese Journal of Hemorheology

摘　　要：目的探讨引起综合ICU严重交通伤患者漏诊的主要因素。方法回顾性分析2007年01月一2010年03月综合ICU收治的严重钝性交通伤患者，按是否出现漏诊分为漏诊组和无漏诊组。临床观测指标包括年龄、性别、GCS、ISS、APACHEⅡ评分、影像学检查、漏诊（包括漏诊率和引起漏诊的主要因素）。结果符合入选标准的患者共123例，其中漏诊组24例，无漏诊组99例。漏诊发生率为19．5l％，漏诊主要部位是胸、腹部。76．09％引起漏诊的主要因素是可以避免的，最常见的是评估不充分，其中不合理影像学评估是最主要因素，其次是临床评估不充分。结论在严重交通伤早期诊治中，引起漏诊的主要因素是评估不充分，包括临床评估不充分和不合理影像学评估。Objective To explore the main factors causing missed injuries of patients with severe traffic trauma in our general ICU. Methods Patients with severe blunt traffic trauma admitted to our general ICU from January 2007 to March 2010 were retrospectively analyzed.According to whether leading to missed injuries were divided into the none-missed-injuries group and the missed-injuries group.Clinical parameters included age,gender, ISS,APACHE II score,missed injuries（including the rate of missed injuries and the main factors causing missed injuries）. Results A total Of 123 patients were enrolled.Of these,there were 99 cases in nonemissed-injuries group and 24 cases in missed-injuries group.The incidence of missed injuries was 19.5 l%.Missed injuries were mainly located in the chest and abdomen.76.09% of the main factors causing missed injuries could be avoided,the most common was to inadequate assessment,in which the most important factor was unreasonable radiographic evaluation,followed by inadequate clinical assessment. Conclusion During the early diagnosis and treatment of severe traffic injuries,the main factors causing missed injuries were inadequate assessment, including inadequate clinical assessment and unreasonable radiographic evaluation.

关 键 词：ICU 严重交通伤 漏诊 

分 类 号：R459.7[医药卫生—急诊医学]