104例创伤性休克救治的回顾性分析

目的　探讨影响创伤性休克预后的相关因素和治疗措施。方法　对 10 4例创伤性休克患者的伤情和救治过程进行回顾性研究 ,采用二维Logistic回归方法 ,对患者年龄 ,创伤严重程度评分 ,伤后就诊时间 ,是否手术 ,输液、输血量等因素进行统计分析。结果　在全部病例组中 ,是否手术、伤后就诊时间、创伤严重程度评分对患者预后的相对系数 (B)分别为 :- 1 84 5 ,- 0 4 2 7,- 0 12 7。就诊时血压及输液量对预后的相关系数分别为 :0 0 14和 0 0 0 2。手术组死亡率为 8/ 75 (11% ) ,非手术组死亡率为 19/ 2 9(6 9% ) ,组间比较 χ2 =32 7,P <0 0 0 1。结论　患者是否接受手术、创伤严重程度评分、伤后就诊时间是影响创伤性休克患者预后的重要因素 ;对创伤性休克患者的救治越早越好 ,在病情稳定后应积极进行手术治疗 ;输液量的多少并不能显著改变患者的预后 ,不主张在活动性出血得到控制前大量补液 ,提倡早期中等量、快速补液。

Treatment of traumatic shock-analysing of 104 cases

Objective To investigate the related factors and treatment that predict the outcome of traumatic shock.Methods One hundred and four (104)patients with traumatic shock were studied retrospectively,and their age,injury severity scale,time to hospital after injury,operation,blood pressure and fluid resuscitation volume etc were analyzed by binary logistic regression to show the relationship between the factors and the outcome. Objective To investigate the related factors and treatment that predict the outcome of traumatic shock.Methods One hundred and four (104)patients with traumatic shock were studied retrospectively,and their age,injury severity scale,time to hospital after injury,operation,blood pressure and fluid resuscitation volume etc were analyzed by binary logistic regression to show the relationship between the factors and the outcome.[WT5"HZ Result To the whole patients'outcome,the coefficients of operation,time to hospital after injury and injury severity scale are-1.845,-0.427 and -0.127,while the coefficients of blood pressure and fluid resuscitation volume are 0.014 and 0.002.The mortality of operation group is 11%,while the non-operation group's is 67%,the Chi-square value between these two groups is 32.7,P<0.001.Conclusion Operation,time to hospital after injury and injury severity scale are the most important factors to predict the outcome of traumatic shock.Fluid resuscitation volume dosen't influence the outcome significantly,however,early and rapidly fluid resuscitation with moderate volume is recommended.