胸腹联合伤与胸腹多发伤的比较研究

目的比较胸腹联合伤（TACI）和胸腹多发伤（TAMI）的临床特点和伤情，以指导创伤的救治。方法167例胸腹腔脏器同时损伤的患者，根据膈肌是否损伤，分为TACI组和TAMI组，比较两组的损伤情况和临床特点，并应用创伤评分系统进行创伤严重度评估。结果全组死亡16例，总死亡率为9．6％。其中TACI组，死亡5例（14．3％），TAMI组11例（8．3％）。胸腹联合伤组与胸腹多发伤组间生理评分RTS、解剖评分中胸部AIS差异无统计学意义，但腹部AIS胸腹联合伤组高，GCS胸腹联合伤组高，ISS胸腹多发伤组高，均有统计学意义。结论TACI和TAMI在临床进程、伤情轻重及治疗结果等方面都有明显的差别，应采取相应的治疗措施，减少并发症，改善预后。

Comparative Study of Thoracoabdominal Combined Injuries and Thora-coabdominal Multiple Injuries

Objective To compare the clinical features and severity of thoracoabdominal combined injuries(TACI) and thoracoabdominal multiple injuries(TAMI) so as to guide the diagnosis and management of trauma. Methods A total of 167 cases of chest trauma complicated by abdominal trauma were reviewed and divided into two groups. Group TACI(132 cases) was associated with diaphragmatic rupture but group TAMI(35 eascs)not. The injury features and the clinical characteristics of both groups were analyzed and the trauma severity of two groups e-valuated by trauma score system. Results The overall mortality was 9.6 %(16/167)of all the cases. The mortality was 14.3% in group TACI (5/35)and 8.3% in group TAMI(11/132). There was no significant difference in revised trauma score(RTS) and thoracic Abbreviated Injury Scale(MS) between the two greups(P> 0.05),but the patients in the TACI group had higher Glasgow Coma Scale(C, CS)and abdominal AIS (P < 0.05), and the patients in the TACI group had higher injury severity scale (ISS) (P < 0.01). Conclusion TACI and TAMI have differ-ence in clinical characteristics,injury severity and treatment results. So it is necessary to take different measurements to reduce the complica-tions and improve the prognosis.