重症胸部创伤患者的病死现状及危险因素分析  

Analysis of mortality and risk factors in patients with severe chest trauma

作　　者：吴静承 李琦 王静国 WU Jingcheng;LI Qi;WANG Jingguo(Department of Emergency,Lanxi Peopled Hospital^Lanxi 321000,China)

机构地区：[1]兰溪市人民医院急诊科,浙江兰溪321000

出　　处：《健康研究》2022年第6期696-699,共4页Health Research

摘　　要：目的 统计重症胸部创伤患者的死亡情况,探究可能导致患者死亡的危险因素。方法 回顾298例重症胸部创伤患者的临床资料,统计患者死亡情况,采用回归性分析可能导致患者死亡的危险因素。结果 298例重症胸部创伤患者中,死亡26例,死亡率8.72%;单因素分析结果显示,不同性别、体重指数(BMI)、致伤原因和是否血气胸的重症胸部创伤患者间,死亡率差异无统计学意义(均P>0.05);不同年龄、基础疾病史及是否多发伤、失血性休克、急性呼吸窘迫或呼吸衰竭、肺部感染、肺挫伤和合并症的重症胸部创伤患者间,死亡率差异具有统计学意义(均P<0.05)。多因素分析结果显示,年龄≥60岁、有基础疾病史、出现多发伤、失血性休克、急性呼吸窘迫或呼吸衰竭、肺部感染、肺挫伤和合并症是导致重症胸部创伤患者死亡的危险因素(均P<0.05)。结论 年龄越大、基础疾病越多、胸部受创出现多发伤、失血性休克、急性呼吸窘迫或呼吸衰竭、肺部出现感染和挫伤、以及合并其他部位损伤的患者在胸部重创后更易发生死亡,临床在针对性预防和急救时需警惕以上危险因素。Objective To count the death of patients with severe chest trauma and explore the risk factors that may lead to death. Methods The clinical data of 298 patients with severe chest trauma were reviewed, and the mortality of the patients was counted.Regression analysis was used to analyze the risk factors that may lead to the death of patients. Results Among 298 patients with severe chest trauma, 26 died, with a mortality rate of 8.72%. Univariate analysis showed that there was no significant difference in mortality among patients with severe chest trauma of different gender, body mass index(BMI), cause of injury, and whether hemopneumothorax or not(P>0.05). There were significant differences in mortality among patients with severe chest trauma of different ages and basic disease histories, whether multiple injuries or not, whether complicated with hemorrhagic shock, acute respiratory distress or respiratory failure, pulmonary infection, pulmonary contusion and complications(all P<0.05).Multivariate analysis showed that age≥60 years, history of basic diseases, multiple injuries, hemorrhagic shock, acute respiratory distress or respiratory failure, pulmonary infection, pulmonary contusion and complications were the risk factors for death of patients with severe chest trauma(all P<0.05).Conclusions The patients who are older, have more basic diseases, suffer from multiple injuries, hemorrhagic shock, acute respiratory distress or respiratory failure, lung infection and contusion, and are combined with injuries in other parts of the chest are more likely to die after severe chest injuries. The above risk factors need to be vigilant in targeted prevention and emergency treatment in clinical practice.

关 键 词：重症胸部外伤 死亡率 危险因素 

分 类 号：R655[医药卫生—外科学]