胸部穿透性损伤解剖评分重伤值的探讨  

Study on anatomical score of patients injured from penetrating thoracic trauma

作　　者：万亚红[1] 石应康[1] 杨建武 忠方强 

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：《中华创伤杂志》2001年第3期135-137,共3页Chinese Journal of Trauma

基　　金：卫生部科学研究基金资助项目 (98-1-2 2 7)

摘　　要：目的　探讨穿透性胸部损伤 (PTT)创伤评分指标预测生死结局的效果 ,界定损伤严重度评分 (ISS)、穿透伤指数 (PTI)的重伤值 ,对PTI和ISS进行比较。　方法　 2 95例PTT分为生存组 2 86例和死亡组 9例 ,以胸AIS、ISS和PTI作为评分指标进行创伤评分 ,比较两组创伤评分和院前时间的差别。对全组ISS、PTI与死亡率的关系分组段分析 ,将PTI和ISS进行比较。　结果　生存组与死亡组创伤评分和院前时间比较 ,差异有显著性意义 (P <0 .0 5 ) ,ISS值在 2 0～ 2 5组段死亡率为 14.81% ,PTI值在 16～ 19组段死亡率为 7.14% ,两者分别与 10 %比较 ,差异无统计学意义 (P >0 .0 5 ) ;PTI与ISS有线性正相关关系 (r=0 .74,P <0 .0 0 1) ,PTI的区别度明显大于ISS ,PTI的死亡误判率低于ISS。　结论　建议增加院前时间作为创伤评分指标 ,ISS和PTI重伤值界定分别为≥ 2 0和≥ 16 ,评价PTT以PTI优于ISS。Objective To study the effects of trauma score in the prognostic survivals and deaths for the patients injured from pen etrating thoracic trauma (PTT), and to define the severe injury using injury severity score (ISS) and penetrating trauma index (PTI). Methods Two hundred and ninety-five patients with PTT were assessed with abbreviated injury scale (AIS), ISS and PTI and divide d into the survival group (286 cases) and the death group (9 cases). Va rious trauma scores and prehospital time were compared between the two groups. The relationship between the mortality and the scores of ISS and PTI wer e estimated and compared. Results The trauma score and prehospital time showed si gnificant difference between the two groups(P<0.05). The mortalit y at 20～25 ISS group and 16～19 PTI group were 14.81% and 7.14%, respectively. There were no significant difference between them and 10% mortality (P>0.0 5). There was a positive linear correlation between PTI and ISS (r=0.74, P<0.001). Difference of PTI between the survival group and the death gro up was bigger than that of ISS. Mistake justice of non-survivals of PTI in the death group was lower than that of ISS. Conclusions it is suggested that prehospital time should be regarded as one of trauma scores. ISS≥20 and PTI≥16 may be define d as severe injury. PTI may be a better index for assessment of PTT than ISS.

关 键 词：胸部损伤 损伤严重度评分 穿透伤指数 创伤评分 

分 类 号：R641[医药卫生—外科学]