老年创伤患者院前急救临床特征分析  

Clinical analysis on the characteristics of first-aid for senile trauma patients before hospitalization

作　　者：周伟梁[1] 秦伟毅[1] 袁野[1] 曾凡杰[1] 唐绍辉[1] 

机构地区：[1]广州军区广州总医院急诊科,广东广州510010

出　　处：《现代预防医学》2014年第20期3826-3828,共3页Modern Preventive Medicine

基　　金：广东省科技厅基金项目:急性胸痛救治规范化流程暨"胸痛中心"建设的研究(2011B031800204)

摘　　要：目的分析院前急救老年创伤患者临床特征,为减少创伤发生,提高创伤救治成功率提供科学依据。方法回顾分析2009年1月至2012年6月300例老年创伤患者临床资料。结果 300例院前急救的老年创伤患者中,男性病例174例（58.00%）,女性病例126例（42.00%）;年龄60~89岁,平均年龄68.4岁,60~69岁198例（66.00%）,70~79岁76例（25.33%）,80岁以上26例（8.67%）,病死率为21.00%（63/300）;交通事故伤占42.33%（127/300）,社会治安伤占8.67%（26/300）,爆炸伤占6.00%（18/300）,锐器伤占8.00%（24/300）,火灾伤占7.00%（21/300）,跌打伤占13.00%（39/300）,其他伤占15.00%（45/300）;创伤评分（TS）（15.3±2.7）分,格拉斯哥昏迷评分（GCS）（12.5±3.2）分。创伤严重程度评分（ISS）（26.4±12.4）分的死亡率差异有统计学意义（χ2=39.63,P〈0.01）;骨折伤257例,非骨折伤43例;颅骨骨折21例（8.17%）,肋骨骨折28（10.89%）,上肢骨折89例（34.63%）,下肢骨折65例（25.29%）,其他骨折54例（21.02%）;骨折伴血（气）胸19例（6.33%）,伴肝脾挫伤27例（9.00%）,伴多处软组织损伤51例（17.00%）;实施确定性抢救手术时间：抢救脱险组（52±24）min,死亡组（89±35）min,2组差异有统计学意义（t=9.7891,P〈0.01）,而2组间的休克发生率、ISS评分及年龄差异均无统计学意义（P〉0.05）;死因特征：MODS 85.71%（54/63）,ARDS 12.70%（8/63）,感染性休克1.59%（1/63）;59例留有后遗症（24.89%）。结论老年创伤病情复杂,及早实施确定性抢救手术时间,有利于提高救治成功率,降低病死率。Objective The purpose of this study was to perform clinical analysis on the characteristics of first-aid for senile trauma patients before hospitalization, in order to improve first-aid success rate when trauma occurs and provide scientific basis. Methods Cases information on 300 senile clinical trauma patients from January 2009 to June 2012 was reviewed and analyzed. Results Among the 300 first-aid senile trauma patients before hospitalization, the number of male cases was 174 （58.00%）, the number of female cases was 126 （42.00%）. The ages of the patients were between 60 and 89 years old, with an average age of 68.4. There were 198 patients with ages from 60 to 69 years olds （66.00%）, 76 patients with ages from 70 to 79 years olds （25.33%）, and 26 patients with ages above 80 （8.67%）. The death rate was 21.00% （63/300）. Traffic accident injury took up 42.33% （127/300）. Social security injury took up 8.67% （26/300）. Explosion injury took up 6.00% （18/300）. Sharp weapon injury took up 8.00% （24/300）. Fire injury took up 7.00% （21/300）. Traumatic injury took up 13.00% （39/300）. Other injury took up 15.00% （45/300）. Trauma scores OrS） was15.3 ± 2.7, and GCS was 12.5 ± 3.2. The difference of death rate from ISS was （26.4 ± 12.4） statistically significant （x2=39.63, P〈0.01）. There were 257 cases of fracture injury, and 143 cases without fracture injury.. There were 21 cases of skull fracture （8.17%）, 28 eases of rib fracture （10.89%）, 89 cases of upper limb fracture （34.63%）, 65 cases of legs fracture （25.29%）, 54 cases of other fracture （21.02%）. There were 19 cases of fracture combined with blood （gas） chest （6.33%）, 27 cases of contusion of liver and spleen （9.00%）, and 51 cases of multiple soft tissue injury （17.00%）. For the definite rescue operation time： emergency escape group was52 ~ 24 min, death group was 89 ± 35 rain, and the differences was statistically significant （t=9.7891, P〈0.01）. For the sho

关 键 词：院前急救 老年患者 创伤 急救 特征 

分 类 号：R641[医药卫生—外科学]