严重骨盆骨折合并多发伤的早期急诊救治流程评估  

Evaluation of early emergency care process for severe pelvic fractures combined with multiple trauma

作　　者：陆健[1] 钱永兵[1] 夏丰[1] 俞康龙[1] 王瑞兰[1] 车咏梅[1] 

机构地区：[1]上海交通大学附属第一人民医院危重病科,201620

出　　处：《中华创伤杂志》2012年第4期296-300,共5页Chinese Journal of Trauma

摘　　要：目的评价严重骨盆骨折合并多发伤的早期急诊流程。方法选择2007年1月-2011年5月收治113例严重骨盆骨折合并多发伤患者，其中2007年1月-2008年5月（建立创伤团队前）收治组26例，2008年6月-2011年5月（建立创伤团队后）收治组87例，比较建立创伤团队前、后不同阶段患者的急诊死亡率，并分析年龄、性别、ISS评分、骨折类型、受伤机制、转运时问、合并伤数量、初始血压、初始血红蛋白和输血量与死亡的关系。结果建立创伤团队后患者的死亡率为23％，显著低于以前阶段死亡率46％，且死亡率与ISS评分和有两个部位以上合并伤呈显著相关性，而与年龄、性别、骨折类型、受伤机制、转运时间、初始血压和初始血红蛋白以及输血量无关。结论采用基于创伤团队的规范化流程可以有效处理严重骨盆骨折合并多发伤的患者，并可以降低死亡率。Objective To evaluate the early emergency management process for severe pelvic fractures combined with multiple trauma. Methods The study involved 113 patients with severe pelvic fractures combined with multiple trauma treated from January 2007 to May 2011. The patients were divid- ed into two groups, ie, before trauma team establishment （26 patients treated from January 2007 to May 2008 ） and after trauma team establishment （87 patients treated from June 2008 to May 2011 ） in accord- ance with the establishment period of trauma team in June 2008. The mortality was compared before and after application of trauma-team-based algorithm with damage control resuscitation, external fixation and angiographic embolizatiou. Variables including age and gender distribution, ISS score, injury type and mechanism, transportation time, associated injury number, initial systolic presst^re hemoglobin and blood transfusion were analyzed for study of their reXation with mortality. Results After trauma team estab- lishment, the mortality （23%） was significantly lower than before trauma team establishment （46%）. The mortality showed significant relation to ISSN score and over two regions of associated injury, but showed no correlation with age and gender distribution, injury type and mecharfism, transportation time initial systolic pressure hemoglobin, and blood transfusion. Conclusion The application of trauma team is effective in treatment of severe pelvic fractures combined with multiple trauma and can decrease the mortality.

关 键 词：多处创伤 急救医疗服务 骨盆 

分 类 号：R641[医药卫生—外科学]