严重腹部创伤后短期死亡原因调查及危险因素的回顾性分析  

Retrospective Analysis of the Risk Factors and the Causes of short-term Death after Severe Abdominal Trauma

作　　者：刘士会[1] 吕良峰[1] 胡成文 LIU Shihui;LV Liangfeng;HU Chengwen(The First People's Hospital of Bengbu, Anhui Bengbu 233000, China)

机构地区：[1]安徽省蚌埠市第一人民医院普外科

出　　处：《河北医学》2020年第2期307-311,共5页Hebei Medicine

基　　金：安徽省蚌埠市科技计划项目，(编号:20130318)

摘　　要：目的:分析严重腹部创伤后短期死亡的原因及危险因素。方法:回顾性分析80例严重腹部损伤患者的临床资料,根据结局将患者分为死亡组和存活组,分析患者死亡原因,比较两组性别、年龄、受伤至入院时间、手术时间、损伤分类、入院时伤情评估结果、相关指标检测结果、是否采取心肺脑复苏等资料。采用多因素Logistic回归分析明确严重腹部创伤后短期死亡的危险因素。结果:80例患者中15例死亡(18.75%)。死亡原因:中枢性呼吸循环功能衰竭6例(40.00%)、创伤性休克4例(26.67%);急性呼吸窘迫综合征3例(20.00%);多器官功能衰竭2例(13.33%)。死亡患者中年龄>60岁、多发伤、ISS评分≥16分的占比显著高于存活患者(P<0.05),同时入院时死亡患者的体温显著低于存活患者、APCAHEⅡ评分、碱剩余、PT、显著高于存活患者(P<0.05)。Logistic多元回归分析,结果显示,年龄、APCAHEⅡ评分、多发伤、ISS评分为严重腹部创伤后短期死亡的独立危险因素(P<0.05)。结论:严重腹部创伤患者的死亡原因以中枢性呼吸循环功能衰竭及创伤性休克为主,且与患者年龄、APCAHEⅡ评分、多发伤、ISS评分密切相关。Objective:To analyze the causes and risk factors of short-term death after severe abdominal trauma.Methods:The clinical data of 80 patients with severe abdominal injuries were retrospectively analyzed.According to the outcome,the patients were divided into death group and survival group.The cause of death was analyzed.The causes of death of the patients were analyzed,and the data of gender,age,time from injury to admission,operation time,injury classification,assessment results of injury at admission,detection results of relevant indicators,and whether cardiopulmonary resuscitation was adopted were compared between the two groups.Multivariate Logistic regression analysis was used to identify the risk factors for short-term death after severe abdominal trauma.Results:15 of 80 patients died(18.75%).Causes of death:central respiratory and circulatory failure in 6 cases(40.00%),traumatic shock in 4 cases(26.67%);acute respiratory distress syndrome in 3 cases(20.00%);multiple organ failure in 2 cases(13.33%).The proportion of patients with age>60 years old,multiple injuries,ISS score≥16 was significantly higher than that of patients with survival(P<0.05),while the body temperature of patients with death at admission was significantly lower than that of patients with survival,ApacheⅡscore,alkali surplus,Pt,and significantly higher than that of patients with survival(P<0.05).Logistic multiple regression analysis showed that age,apcaheⅡscore,multiple injuries and ISS score were independent risk factors for short-term death after severe abdominal trauma(P<0.05).Conclusion:The cause of death in patients with severe abdominal trauma is central respiratory and circulatory failure and traumatic shock,and is closely related to patient age,APCAHE II score,multiple trauma,and ISS scores.

关 键 词：严重腹部创伤 短期死亡 死亡原因 危险因素 

分 类 号：R641[医药卫生—外科学]