天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (8): 885-888.doi: 10.11958/20170171

• 临床研究 • 上一篇    下一篇

急诊多发伤患者死亡的影响因素分析

王庚壮 1， 潘昭宇 2， 潘立峰 1△   

  1. 1 天津医科大学附属第四临床学院普外一科 （邮编 300140）； 2 天津市实验中学高二 （10） 班
  • 收稿日期:2017-02-10 修回日期:2017-06-26 出版日期:2017-08-15 发布日期:2017-08-15
  • 通讯作者: △通讯作者 E-mail: plf1014@126.com E-mail:plf1014@126.com

The analysis of influencing factors of emergency death in multiple trauma patients

WANG Geng-zhuang1, PAN Zhao-yu2, PAN Li-feng1△   

  1. 1 Department of General Surgery, the Fourth Affiliated Clinical Hospital of Tianjin Medical University, Tianjin 300140, China; 2 Sophomore 10 Class of Tianjin Experimental Middle School
  • Received:2017-02-10 Revised:2017-06-26 Published:2017-08-15 Online:2017-08-15
  • Contact: △Corresponding Author E-mail：plf1014@126.com E-mail:plf1014@126.com

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摘要： 目的 分析急诊多发伤患者死亡的相关因素以及独立危险因素。方法 回顾性分析本院急诊 2012 年 6 月—2015 年 6 月救治的 651 例严重多发伤患者资料， 根据患者结局分为成功组 （608 例） 与死亡组 （43 例）， 比较 2 组 患者性别、 年龄、 致伤原因、 与本次外伤相关的原发疾病、 损伤程度评分法 （ISS） 评分、 创伤数量、 受伤至就诊时间以及 受伤部位等指标差异， 并采用 Logistic 回归分析患者死亡的危险因素。结果 死亡组年龄≥60 岁、 ISS 评分≥16 分、 创伤数量≥4 处、 颅脑有主要损伤以及受伤至就诊时间≥3 h 比例均高于成功组 （均 P＜0.05）。患者年龄≥60 岁、 受伤 部位 （颅脑）、 ISS 评分≥16 分和受伤至就诊时间≥3 h 为多发伤病患急诊死亡的独立危险因素。死亡组患者致死原因 以脑挫裂型颅脑创伤占比最高， 达 27.91%（12 例）， 颅内血肿占 20.93%（9 例）， 创伤型血胸占 11.63%（5 例）。结论 上述独立危险因素应引起急诊医生的重点关注， 据此制定急救预案， 以降低多发伤病患者的死亡率。

关键词: 多处创伤, 急诊处理, 死亡, 危险因素

Abstract: Objective To analyze the related factors and the independent risk factors of death in patients with multiple injuries. Methods Data of 651 patients with multiple injuries treated in our hospital from June 2012 to June 2015 were retrospectively analyzed. According to the outcomes, patients were divided into effective group (n=608) and death group (n= 43). Data of gender, age, cause of injury, the primary diseases related with the trauma, ISS score, number of trauma, time from injury to the treatment and the body parts of injury were compared between two groups. Logistic regression analysis was used to analyze the risk factors of death in multiple trauma patients. Results The proportion of patients≥60 years old, ISS score ≥16 points, the number of trauma≥4, a major brain injury and time of trauma to the treatment ≥ 3 h were higher in death group than those of effective group (P＜0.05). The independent risk factors for emergency death in multiple injuries included patients≥60 years old, major brain injury, ISS score ≥16 points and time of trauma to the treatment ≥ 3 h. The cause of death in patients with craniocerebral trauma (cerebral laceration) accounted for up to 27.91% (n=12), intracranial hematoma accounted for 20.93% (n=9), and traumatic hemothorax accounted for 11.63% (n=5). Conclusion The related factors and independent risk factors should be paid attention to doctors in emergency department, and the emergency plan should be made to reduce the death rate of emergency patients with multiple injuries.

Key words: multiple trauma, emergency treatment, death\risk factors