严重多发伤的早期救治

目的 探讨严重多发伤的早期救治方法。方法 总结1990年1月-2003年12月救治的严重多发伤2358例临床资料(其中2145例接受了ICU监护和治疗),分析严重多发伤早期救治中的几个重要问题,并提出救治工作的要点。结果 本组早期诊断正确率95.04％(2 241／2 358)。发生ARDS 228例(9.67％),MODS 236例(10％),应激性溃疡伴出血103例(4.37％)。ARDS治愈率69.30％(158／228);MODS治愈率53.81％(127／236);应激性溃疡治愈率74.75％(77／103)。全组总治愈率89.86％(2 119／2 358),死亡率10.14％(239／2 358)。结论 提高早期诊断率、合理应用损伤控制外科技术、及时修复及动脉栓塞治疗腹膜后血管损伤等措施对提高严重多发伤的救治成功率至关重要。

Early treatment of severe multiple traumas

Objective To investigate the early treatments of severe multiple traumas. Methods The clinical data of 2 358 patients with severe multiple trauma from January 1990 to December 2003 in our hospital were studied. The problems in early care of severe multiple trauma were analyzed,and the keys of it were put forward. Results The diagnosis rate was 95.04% (2 241/2 358) . The incidence of ARDS, MODS and stress stomach ulcer were 9.67% , 10% , and 4. 37% respetively. Cure rate of ARDS, MODS and stress ulcer were 69. 30% (158/228), 53. 81% (127/236), and 74.75% (77/103)respetively. Cure rate of all patients was 89.86% (2 119/2 358), mortality rate was 10.14% (239/2 358). Conclusion It is important and essential for a successful treatment to improve accurate rate of earlier diagnosis, adopt damage control sugery, repair blood vessel and treat retro-peritoneal injuries by arterial embolism.