胸部闭合伤的损伤严重度评估及临床意义  

Evaluation of Injury Severity in Closed Injury of Chest and Its Clinical Significance

作　　者：武忠[1] 方强[1] 石应康[1] 杨建[1] 万亚红[1] 

机构地区：[1]华西医科大学附属第一医院胸心外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2001年第2期98-100,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：卫生部科研基金资助项目! (98-1-2 2 7)&&

摘　　要：目的　探讨胸部闭合伤的临床特点及其损伤严重度评估的临床意义。　方法　分析 45 6例胸部闭合伤的致伤因素和死亡率 ,并按有无合并伤 (分为单纯胸伤组、合并伤组 )和结局 (分为生存组、死亡组 )分组进行创伤评分 ,分别比较不同组间的损伤严重程度。　结果　致伤原因为交通伤发生率最高 (6 0 .97% ) ,其次为高处坠落伤 (13.82 % )。45 6例中 2 88例合并其它部位损伤 ,占 6 3.16 %。死亡 18例 ,死亡率 3.95 %。单纯胸伤组的格拉斯哥昏迷指数 (GCS)、修正创伤评分 (RTS)和生存概率 (Ps)较高 ,损伤严重度评分 (ISS)低于合并伤组 ,胸部简明损伤定级 (AIS)评分两组间差别无显著性意义。死亡组和生存组比较 ,前者生理评分低 ,解剖评分高 ,生存概率亦低。　结论　胸部闭合伤常合并全身多发伤 ,伤情判断困难。合理使用创伤评分有助于判断损伤严重度 ,指导临床救治。Objective To evaluate the character of closed injury of chest and the clinical significance of trauma score. Methods Four hundred and fifty-six closed injury of chest cases were divided into different groups according to their injury condition (chest injury group and multiple injuries group) and outcome (survival group and death group), then trauma scores were compared respectively. In addition, the causes of injuries and mortality rate were analyzed. Results The incidence of traffic accident was the highest. In 456 cases, 18 cases died (3.95%), 288 cases had multiple injuries (63.16%). There was no significant difference in thoracic abbreviated injury scale (AIS) between the chest injury group and multiple injuries group. The Glasgow coma scale (GCS), revised trauma score (RTS) and probability of survival (Ps) were higher, while the injury severity score (ISS) was lower in chest injury group. Compared with survival group, there were lower GCS, RTS, Ps and higher ISS, thoracic AIS in death group. Conclusion The incidence of multiple injuries is very high in closed injury of chest. Applying trauma score is conducive to the judgement of injury severity.

关 键 词：胸部闭合伤 创伤评分 损伤严重度 

分 类 号：R655[医药卫生—外科学]