粤北区域医疗中心急性严重创伤患者早期死亡相关因素分析  

Related factors of early death in emergency patients with severe trauma in northern Guangdong regional medical center

作　　者：毛文杰 席新华 MAO wenjie;XI Xinhua(Yuebei People's Hospital,Medical College of Shantou University,Shaoguan Guangdong 512026,China)

机构地区：[1]汕头大学医学院附属粤北人民医院,广东韶关512026

出　　处：《中国急救复苏与灾害医学杂志》2023年第10期1327-1330,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：韶关市卫生健康科研项目(编号:Y23039)。

摘　　要：目的 分析探讨急性严重创伤患者早期死亡相关危险因素。方法 选取2020年1月—2021年1月在粤北人民医院接受救治的168例严重创伤患者。将所有患者按照72 h内是否死亡分为存活组和死亡组,通过单因素及多因素Logistic回归方程对患者性别、年龄、职业、所属地、受伤时间段、受伤机制、入院体温、基础疾病、休克指数、GCS评分、受伤部位、是否手术、手术时长、输血量、术前凝血功能等相关因素进行分析,寻找急性创伤患者死亡的独立危险因素。结果 一般资料统计分析结果显示:重物压伤致死率最高(25%);交通意外致死人数最多,是导致死亡的主要受伤机制;受伤部位中,头、胸部既是最常见的急性创伤受伤部位,也是病死率最高的急性创伤受伤部位。经单因素分析,年龄、所属地、头胸部损伤、入院体温、基础疾病、休克指数、GCS评分、是否手术、凝血功能是否严重异常、输血量差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,所属地、头胸部损伤、休克指数、GCS评分、是否手术是严重创伤患者死亡的危险因素(P<0.05)。结论 临床需对急性创伤患者进行准确的GCS评分,有手术指征的需及时进行手术干预,改进抢救策略,提高抢救质量,同时加大宣传力度增强民众安全意识,才能有效降低急诊严重创伤患者早期病死率。Objective To analyze the risk factors for early death in patients with acute severe trauma.Methods A total of 168 patients with severe trauma who were treated in Yuebei People's Hospital from January 2020 to January 2021 were selected.All patients were divided into survival group and death group according to whether they died within 72 hours.Univariate and multivariate Logistic regression equations were used to analyze the gender,age,occupation,place of affiliation,time period of onset,time interval from onset to admission,injury mechanism,admission temperature,whether there were underlying diseases,shock index,GCS score,injury site,operation,operation duration,blood transfusion volume,preoperative coagulation function and other related factors.To find the independent risk factors of death in emergency trauma patients.Results The death rate of heavy injuries was the highest(25%);and the death rate of traffic accidents was the highest,which was the main injury mechanism leading to death.The head and chest were not only the most common emergency trauma sites,but also the most common emergency trauma sites with the highest mortality rate.By single factor analysis,there were statistically significant differences in age,admission temperature,GCS score,and whether or not to undergo surgery between the two groups(P<0.05).Multivariate Logistic regression analysis showed that GCS score and surgery were risk factors for death in patients with severe trauma(P<0.05).Conclusion Accurate GCS score for acute trauma patients,timely surgical intervention for patients with surgical indications,improvement of rescue strategies,improvement of rescue quality,and increase of publicity to enhance public safety awareness can effectively reduce the mortality of emergency trauma patients.

关 键 词：急性创伤 死亡原因 危险因素 救治对策 急救 

分 类 号：R459.7[医药卫生—急诊医学]