急救部开展创伤急救手术1673例

目的：探讨急救部开展创伤急救手术的可行性和救治效果，方法：急救部在4年时间内开展各部位创伤急救手术1673例，其中开颅探查术259例，开胸探查术55例，开腹探查术205例，四肢长骨骨折切开复位内固术768例，血管，神经、肌腱吻合术242例，颈部伤及全身多处软组织撕脱伤的清创缝合术141例，脊柱或骨盆手术3例，结果：本组术后痊愈1567例，死亡106例，其中颅脑外伤术后死亡96例，心脏刀刺伤术中死亡1例，严重多发伤术后并发多器官功能不全综合征（MODS）死亡6例，并发感染性休克死亡1例，并发急性呼吸窘迫综合征（ARDS）死亡2例，死亡的主要原因为严重的颅脑外伤，心脏刀刺伤，MODS，ARDS，感染等，术后发生并发症者362例，主要并发症为低血容量性休克103例，感染性休克86例，心源性休克12例，ARDS92例，MODS58例，骨折延迟愈合或骨不连11例，结论：急救部应开展各部位创伤的手术急救，以降低创伤患者并发症的发生率和死亡率。

First aid treatment of 1 673 cases of trauma in emergency department

Objective To discuss the feasibility and curative effect of the first aid treatment of trauma in the Emergency Department. Methods During the past 4 years operations were done in 1 673 cases of trauma in the Emergency Department. The operations included 259 cases of exploratory craniotomy, 55 thoracotomy, 205 laparotomy, 768 open reduction and internal fixation for fractures of the long bone, the spine or the pelvis, 242 anastomoses of vessels, nerves and tendons, 141 debridement or suturation because of neck or soft tissue injuries and 3 operation on spinal or pelvic injuries. Results After operation, 1 567 cases recovered and 106 cases died. The reasons for death were severe head injuries (96 cases), penetrating cardiac wounds (1 case), multiple organ dysfunction syndrome (MODS) (6 cases), acute respiratory distress syndrome (ARDS) (2 cases) and septic shock (1 case). After operations, there appeared 362 cases of complications including 103 cases of hypovolemic shock, 86 septic shock, 12 cardiogenic shock, 58 MODS, 92 ARDS and 11 delayed union or nonunion of fractures. Conclusions First aid treatment of trauma should be performed in the Emergency Department in order to decrease the morbidity of complications and the mortality of injured patients.