严重交通伤与坠落伤救治结局比较和创伤急救模式探讨  

Comparative study of severe trauma care outcome and trauma care system probe on road traffic trauma and fall injury

作　　者：都定元[1] 高劲谋[1] 林曦[1] 曾剑波[1] 冉红莉[1] 

机构地区：[1]重庆市急救医疗中心创伤科,重庆市创伤研究所400014

出　　处：《中华创伤杂志》2000年第1期46-48,共3页Chinese Journal of Trauma

摘　　要：目的　进一步提高严重交通伤（ＲＴＴ） 与坠落伤（ＦＩ） 的救治水平。　方法　对重庆急救中心１９９６ 年８ 月～１９９７ 年７ 月救治的严重ＲＴＴ和ＦＩ（ＩＳＳ≥１６ 或ＡＩＳ≥３） 结局进行比较分析。　结果　ＲＴＴ２１９ 例，ＦＩ１１７ 例。严重多发伤组的致死率及其死亡组ＩＳＳ值ＦＩ显著高于ＲＴＴ（ Ｐ＜０ ．０５） ，其腹部和（或） 盆腔脏器伤、上肢伤、下肢和（ 或） 骨盆伤、脊柱伤的发生率ＦＩ显著高于ＲＴＴ（Ｐ＜０ ．０１ 和０．０５） 。严重单发伤组脑伤发生率ＲＴＴ为８２．６％ （９０１０９） ，ＦＩ为７７ ．６ ％ （３８４９）（ Ｐ＞０ ．０５）；致死率ＦＩ明显高于ＲＴＴ（Ｐ＜０ ．０５）。总致死率ＦＩ为３６．８ ％（４３１１７） ，ＲＴＴ为２１．５ ％ （４７２１９）（Ｐ＜０ ．０５）。其中住院死亡率无显著性差异（８．５％ 与８．７ ％ ，Ｐ＞ ０ ．０５） ，院前死亡率ＦＩ显著高于ＲＴＴ（２８．２％ 与１２ ．８ ％ ，Ｐ＜０．０５） 。　结论　强调创伤外科专业化对提高严重创伤住院存活率具有关键意义，院前创伤急救和安全防护研究亟待进一步加强。Objective To make further improvement on severe trauma care outcome of road traffic trauma (RTT) and fall injury (FI). Methods The severe trauma outcome of patients admitted following a road traffic accident or a fall injury from August 1996 to July 1997 was analyzed comparatively. Results There were 219 cases in RTT and 117 in FI. The lethality rate of severe polytrauma (ISS≥16) and the ISS values of death group were significantly higher in FI than that in RTT ( P <0.05). The incidence rate of injury in abdomen and/or pelvic cavity viscera, upper extremities, lower extremities and/or pelvis and spine were significantly higher in FI than that in RTT ( P <0.01, 0.05). The occurrence rate of head injury of severe single body region was 82.6% in RTT and 77.6% in FI ( P >0.05). However, its lethality rate was significantly higher in FI than that in RTT( P <0.05). The total lethality rate in FI and in RTT was 36.8% and 21.5% respectively ( P <0.05).The prehospital mortality rate in FI was significantly higher than that in RTT(28.2% vs 12.8%, P <0.05). There was no obvious difference for the inhospital lethality rate in FI and RTT ( 8.5% vs 8.7%, P >0.05). Conclusions Emphasizing the specialization of trauma surgery plays a vital role to improve inhospital survival rate for severe trauma victims. There is an urgent need for further strengthening of the prehospital care research and attaching great importance to safety education and injury prevention.

关 键 词：交通事故 创伤 急救 坠落伤 

分 类 号：R641[医药卫生—外科学]