伴钝性腹部创伤的多发伤患者死亡危险因素分析

<正>随着工业、交通运输业的发展,创伤的发生率越来越高,成为普通人群中第四位,45岁以下人群中首要的死亡原因1]。严重创伤往往是多发伤,当其它部位与腹部创伤同时存在时,可因腹外损伤症状典型,而忽略了腹部检查,造成漏诊,后果严重。腹部创伤居创伤死亡第三位,其中85%为钝性腹部创伤2]。钝性腹部创伤因病情复杂诊断相对困难,同时变化快,死亡率高,被当作是诊断和治疗的一项挑战3]。如何及时准确的判断伴有钝性腹部创伤的多发伤的严重

Risk factors analysis of mortality in multiple trauma patients with blunt abdominal injuryLIU Chang-feng , ZHANG Bing , YU Yong. Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China.

Objective To explore the risk factors which influence mortality in multiple trauma patients with blunt abdominal injury . Methods The data of 156 multiple trauma patients with blunt abdominal injury were retrospectively reviewed. All the patients were divided into two groups: the survivors group and the death group, and predictors for mortality were assessed in univariate analysis models, as to those factors in significance statistically, multivariate analysis was conducted. Results The univariate determinants of mortality were the pre-hospital time, shock, surgical treatment, injury severity score(ISS), colon injury, liver injury, pancreas injury, mesenteric injury, multi-abdominal organs injury. Age, sex, peritonitis, stomach injury, duodenum injury, small intestine injury, biliary tract injury, spleen injury, renal contusion, omentum injury did not predict increased mortality. Independent risk factors of mortality included shock, ISS, colon injury. In addition, in multivariate analysis, liver injury, colon injury were identified as independent prognostic factors for shock. Conclusion The death of patients with blunt abdominal trauma might be caused by multiple factors. Independent risk factors of mortality included shock, ISS, colon injury. In addition, liver injury, colon injury were identified as independent prognostic factors for shock.