老年人胸部损伤的临床特点与救治策略  

Clinical characteristics and treatment strategies for elderly patients with thoracic trauma

作　　者：钟源波[1,2] 单爱军[1,2] 王进[1,2] 柳勋法[1,2] 

机构地区：[1]深圳市人民医院急诊中心 [2]暨南大学第二临床学院,广东518020

出　　处：《创伤外科杂志》2014年第4期311-316,共6页Journal of Traumatic Surgery

摘　　要：目的分析老年胸部损伤患者的临床特点并探讨救治策略。方法按我院实施急诊一站式综合救治模式的起始点（2010年6月）为时间临界点,采用＂前＂-＂后＂对照方法,回顾性分析我院急诊科于2008年6月-2010年6月收治的老年人胸部损伤患者64例（组1）和2011年12月-2013年12月收治的79例（组2）,两组患者损伤严重度评分（ISS）≥15分。分析老年人胸部损伤特点,比较两组治疗转归等数据。结果老年人胸部损伤以交通伤和摔伤居多（80%）,伤情重,平均入院ISS 35.4分。在急诊一站式综合救治模式下,组2死亡率17.7%,显著低于组1（43.8%）（P〈0.01）。结论老年人胸部损伤并发症多,病情重,死亡率高,预后差,应强调多学科协作模式救治,我院一站式综合性急诊救治模式能够有效降低老年人胸部损伤的死亡率,值得推广。Objective To explore a better access to perform treatment for elderly patients with thoracic trauma via analyzing their clinical characteristics. Methods This was a ＂before and after＂ study. The comprehensive emergency mode has been initiated since Jun. 2010 in our hospital. The clinical data of 79 elderly patients with thoracic trauma who were treated by emergency surgery in our hospital between Dee. 2011 and Dec. 2013 were collected,and the treatment outcome was compared to the outcome of 64 cases from Jun. 2008 to Jun. 2010. The cure rate, the average hospitalization days,the hospital costs and the prognosis were compared between the two groups. All patients were with an index of severity score （ ISS ） more than 15. Results Road traffic trauma and fall injury were the most common causes （ 80% ）. The average ISS for this cohort of patients was 35.4. Patients who were treated under comprehensive emergency mode had a lower mortality （ 17. 7% ） when compared with the prior cohort of patients （43.8 % ） （ P 〈 0. 01 ）. Conclusion The elderly patients suffered from thoracic trauma have more complications and higher mortality rate for which some specific intervention measurements should be vigorously recommended. The comprehensive emergency mode of our hospital which significantly decreases the mortality rate of this kind of patients could be a new and valid treatment strategy.

关 键 词：胸部损伤 肋骨骨折 急救 老年 

分 类 号：R655[医药卫生—外科学]