多发伤患者院内死亡危险因素分析  

Analysis of the risk factors for mortality of patients with multiple injuries

作　　者：苗振军[1] 蔡华忠[1] 魏法星[1] 周峰[1] 刘志祯[1] Miao Zhen-jun;Cai Hua-zhong;Wei Fa-xing;Zhou Feng;Liu Zhi-zhen(Department of Emergency and Trauma Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang 212000, China)

机构地区：[1]江苏大学附属医院急诊创伤外科,江苏镇江212000

出　　处：《中国急救医学》2018年第5期410-413,共4页Chinese Journal of Critical Care Medicine

基　　金：镇江社会发展基金（SH2017025）;江苏大学临床专项基金（JDLCZX012）

摘　　要：目的 分析346例多发伤患者的临床资料,探讨研究影响多发伤患者院内死亡的危险因素.方法 回顾分析2010-12 ～2017-06我院收治的346例多发伤患者临床资料,通过单因素和多因素分析探讨影响多发伤患者预后的危险因素.结果 346例多发伤患者,分成死亡组（n =76例）和存活组（n=270例）,其中年龄、主要致伤部位、损伤严重程度（ISS）评分、入院前时间、合并休克、并发感染及是否急诊手术两组比较差异有统计学意义（P＜0.05）,而性别、致伤原因及损伤部位数目两组比较差异无统计学意义（P＞0.05）.多因素Logistic回归分析显示,合并休克、ISS评分、入院前时间及主要致伤部位是影响多发伤患者预后的独立危险因素（P＜0.05）.结论 多发伤的救治过程中,争取在“黄金一小时”的抢救时间窗内,缩短入院前时间,实施积极有效的液体复苏和损伤控制性手术等措施,重视主要致伤部位的救治和患者ISS评分,可以更好地改善多发伤患者的预后.Objective To analyze clinical data of 346 cases of multiple injuries,and to investigate the risk factors of mortality for multiple injuries.Methods Clinic data of 346 cases with multiple injuries who admitted into our hospital was retrospectively analyzed from December 2010 to June 2017.The risk factors that influent the prognosis of multiple injuries were analyzed by one-way and multivariate analysis.Results The cases were divided into death group （76 cases） and survival group （270 cases）.There were statistical significance in age,ISS scores,main injury parts,time before admission,infection,shock and emergency operation （P ＜ 0.05）.But there was no statistical significance in gender,cause of injury and number of injury parts （P ＞ 0.05）.Logistic regression analysis show shock,time before admission,main injury parts and ISS score were independent predictors of mortality for multiple injuries.Conclusion In the course of treatment of multiple injuries,we should shorten the time before admission,implement active and effective fluid resuscitation and damage control operation,should pay more attention to main injury parts and ISS scores,in this way we can improve the prognosis of multiple injuries.

关 键 词：多发伤 预后 危险因素 死亡原因 

分 类 号：R563.1[医药卫生—呼吸系统]