ICU在严重多发伤救治中的作用  

Role of intensive care unit in treatment of severe multiple trauma

作　　者：施建国 姚远 周继红[2] 李勇[3] 骆建军 侯振海 邱俊[2] 张良[2] 

机构地区：[1]解放军第一七医院交通伤急救中心,杭州310004 [2]第三军医大学附属大坪医院野战外科研究所,交通医学研究所,创伤、烧伤与复合伤国家重点实验室l [3]南京军区后勤部94625部队卫生所

出　　处：《中华创伤杂志》2013年第11期1091-1093,共3页Chinese Journal of Trauma

基　　金：卫生部卫生公益性行业科研专项基金资助项目（201002014）

摘　　要：目的探讨ICU治疗严重多发伤的伤情标准及意义。方法通过分析“中华创伤数据库”收录的解放军第一一七医院交通伤急救中心2006—2012年收治的64例（ISS／〉20分）非死亡严重多发伤患者资料，比较ICU救治组和非ICU救治组在创伤评分、并发症、功能预后及医疗成本等方面的差异。结果两组患者ISS与新损伤严重度评分（newISS，NISS）差异无统计学意义，但GCS和修正创伤记分（revised traumascore，RTS）差异有统计学意义（P〈0．05）；两组患者住院天数和医疗费用等差异无统计学意义，但发生并发症例数和出院时功能独立性评定（functional independence measure，FIM）差异有统计学意义（P〈0．05）。非ICU救治组发生并发症的可能性是ICU救治组的2．96倍。ICU救治组FIM为10．11±2．10，显著高于非ICU救治组（8．67±2．99）（P〈0．05）。结论ISS／〉20分的严重多发伤患者进入ICU治疗有利于降低并发症发生率。Objective To investigate the criteria and significance for management of severe mul- tiple trauma in the intensive care unit （ ICU ）. Methods Data of 64 patients with non-fatal severe multi-trauma （ISS≥20） treated in the First Aid Center for Traffic Injuries in 117th Hospital of PLA be- tween 2006-2012 documented in China Trauma Database were analyzed. Differences in trauma scoring, complications, functional prognosis and medical cost were analyzed between ICU and non-ICU patients. Results There were statistical differences for GCS and revised trauma score （RTS） between ICU pa- tients and non-ICU patients （ P 〈 0.05 ） , but the differences were insignificant for ISS and new ISS （NISS）. Likewise, the differences were significant for complication incidence and functional independ- ence measure （FIM） on discharge （ P 〈 0.05 ）, but not in the length of hospital stay and medical cost. Complication incidence of non-ICU patients was 2.96 times that of ICU patients. FIM of ICU patients scored 10.11 ±2.10, far higher than that of non-ICU patients （P 〈 0.05 ）. Conclusion For severe multiple trauma patients with ISS≥20, the admission to the ICU is helpful for reduction of the complica- tion rate.

关 键 词：多处创伤 数据库 重症监护室 

分 类 号：R641[医药卫生—外科学]