应用骨盆骨折Tile分类预测患者早期输血量的初步研究

目的　研究骨盆骨折Tile分类与患者早期输血量之间的相关性 ,便于预测骨折患者的输血量 ,指导急救早期对血流动力学不稳患者的治疗 ,减少死亡率。方法　回顾性研究 5年间收治的 97例骨盆骨折患者 (包括复合伤患者 ) ,用Kruskal -Wallis非参数统计检验患者在受伤后早期的输血量与Tile骨盆骨折不同分类之间的相关性。结果　三型骨折患者骨折的严重程度与输血量统计学上有显著的相关性。 97例患者平均输血量为 912ml,其中A组平均输血 2 5 2ml,B组为 892ml,C组为2 2 0 0ml;ISS评分平均为 18 4 ,其中C组为 2 8 7。死亡率平均为 5 2 % ,C组平均为 19 0 %。结论　Tile骨折分类方法和骨盆骨折患者输血量具有显著的相关性 ,因而有临床预测价值。骨折类型越严重 ,患者早期复苏时的输血量就越多 ,其中严重类型(C型 )骨折患者平均输血达 2 2 0 0ml以上。

Analysis of the Correlation between the Tile Classification of Pelvic Fracture and the Requirement of Blood Transfusion in the Patients with Pelvic Fracture

Objective To investigate relation between the blood requirement in the patients with pelvic fractures when suffering with massive hemorrhage and the Tile classification of pelvic fracture.So it will be clinically more feasible to predict the requirement of blood transfusion in the patients and therefore,to rescue those with hemodymamic instability and to reduce a mortality in the patients.Methods From June 1995 to October 2000,97 cases of pelvic fracture were admitted to our hospital.The correlation between the Tile classification and the amount of blood transfusion was retrospectively studied with the statistical nonparametric Kruskal-Wallis test.Results There were significantly differences in the respect of requirement of blood transfusion among each group graded as the Tile classification.The mean blood transfusion in this series of patients was 912 ml and those classified as C type needed more than 2200 ml.Five patients(5 2%)died and four of them were in C group.The mortality in C group was 19 0%.Conclusion The Tile classification of pelvic fractures can positively predict the amount of blood transfusion.The severer the fractures are,the more chances of the associated injuries will stand.