影响急诊介入治疗骨盆骨折预后的多因素分析  

Multivariate analysis of the influence of emergency interventional therapy on pelvic fracture prognosis

作　　者：胡添松 何明长[2] 陈水斌[1] 彭新建[1] 欧阳林[1] HU Tiansong;HE Mingchang;CHEN Shuibin;PENG Xinjian;OU Yanglin(Department of Interventional,909 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Zhangzhou,Fujian,363000,China;Department of Orthopedics,909 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army)

机构地区：[1]中国人民解放军联勤保障部队第909医院介入科,福建漳州363000 [2]中国人民解放军联勤保障部队第909医院骨科

出　　处：《临床急诊杂志》2020年第4期277-281,共5页Journal of Clinical Emergency

基　　金：2018年漳州市科技拥军项目(No:ZZ2018KD01)。

摘　　要：目的:探讨与分析影响急诊介入治疗骨盆骨折预后的因素。方法:2014-02-2019-02期间在本院进行急诊介入的骨盆骨折患者160例,调查患者一般资料、骨折情况、临床诊治与预后情况。结果:在160例患者中,经过急诊介入后死亡16例(死亡组),存活144例(存活组),病死率为10.0%。死亡组的性别、年龄、收缩压、体重指数、舒张压、骨折分型、骨折原因、骨折部位与死亡组对比差异无统计学意义(P>0.05),死亡组的伤后到院前时间、合并创伤状况、手术时间、输血情况等与死亡组对比差异有统计学意义(P<0.05)。死亡组入院时的格拉斯哥预后评分(GCS)、简明损伤评分(AIS)、损伤严重程度评分(ISS)、急性生理与慢性健康状况评估Ⅱ(APACHEⅡ)评分与存活组对比差异均有统计学意义(P<0.05)。死亡组急诊期间的呼吸衰竭、休克、感染等并发症发生率为50.0%,显著高于存活组的6.3%(P<0.05)。Logistic回归分析显示GCS评分、AIS评分、ISS评分、APACHEⅡ评分、伤后到院前时间、合并创伤为患者预后死亡的主要影响因素(P<0.05)。结论:骨盆骨折的预后相对比较差,多伴随有各种并发症,GCS评分、AIS评分、ISS评分、APACHEⅡ评分、伤后到院前时间、合并创伤为患者预后死亡的主要影响因素。Objective:To investigate and analysis the factors affecting the prognosis of emergency interventional treatment of pelvic fractures. Method:From February 2014 to February 2019, 160 patients with pelvic fractures who underwent emergency intervention were enrolled in our hospital. The general data, fractures, clinical diagnosis and prognosis were investigated. Result:There were 16 patients died(death group) after emergency intervention and 144 patients survived(survival group) in the 160 patients with the mortality rate of 10.0%. There were no significant differences in gender, age, systolic blood pressure, body mass index, diastolic blood pressure, fracture classification, fracture cause, fracture site compared between the death group and the survival group before the emergency department(P>0.05). There were statistically significant difference between the combined trauma, surgery time, blood transfusion compared between the two groups(P<0.05). The Glasgow coma scale(GCS), abbreviated injury scale(AIS), injury severity score(ISS), acute physiology, age and chronic health evaluation Ⅱ(APACHE Ⅱ) in he death group compared to the death group were statistically significant difference(P<0.05). The incidence of complications such as respiratory failure, shock, and infection during the emergency in the death group was 50.0%, which was significantly higher than that of the survival group(6.3%)(P<0.05). Logistic regression analysis showed that GCS score, AIS score, ISS score, APACHE Ⅱ score, fracture to emergency time, and combined trauma were the main influencing factors of prognosis(P<0.05). Conclusion:The prognosis of pelvic fractures are relatively poor, with many complications. The GCS score, AIS score, ISS score, APACHE Ⅱ score, fracture to emergency time, and combined trauma were the main influencing factors of prognosis.

关 键 词：骨盆骨折 急诊介入治疗 预后 急性生理与慢性健康评分 简明损伤评分 

分 类 号：R683.3[医药卫生—骨科学]