车祸致严重多发性创伤的临床急救分析

目的总结分析车祸所致严重多发性创伤的临床急救特点。方法对本院2009年10月～2011年10月收治的40例车祸致严重多发性创伤患者的临床诊疗资料进行回顾性分析。结果本组40例患者中治愈34例,死亡6例;死亡病例中有3例于接诊后24h内死于不可逆性休克,1例腹部开放性损伤伴肝脾破裂患者于手术后24h内因呼吸循环功能衰竭而死亡,2例颅脑损伤伴颅内血肿患者在手术后48h内因呼吸功能衰竭而死亡;34例治愈患者在治疗中有12例出现急性呼吸窘迫综合征,2例出现急性肾功能衰竭,12例出现多脏器功能衰竭,10例出现应激性溃疡伴出血。结论对于严重多发性创伤患者,接诊后应通过对受伤情况的详细询问以及仔细的体格检查,对病情形成全面的了解,并及时作出准确的伤情评估,尽早实施对重要脏器损伤的救治处理,以提高抢救的成功率,对于腹部损伤,应着重观察是否存在肝脾破裂或肠挫伤等病情,以免漏诊。

The analysis of clinical emergency for severe multiple trauma caused by accidents

Objective To summarize and analyze the clinical emergency features for the severe multiple trauma caused by accidents. Methods The clinical diagnosis and treatment information for the 40 patients with severe multiple trauma caused by accidents from October 2009 to October 2011 were analyzed retrospectively. Results Thrity-four cases were cured in the 40 patients, and 6 cases were died. There were 3 patients died within 24 hours after admissions of irreversible shock, 1 patient with open abdominal injury with liver and spleen rupture 24 hours after surgery died of internal respiratory and circulatory failure. 2 cases of brain injury patients with intracranial hematoma 48 hours after surgery died of internal respiratory failure. 12 patients in the treatment were with acute respiratory distress syndrome in the 34 cases cured, 2 cases were of acute renal failure, 12 patients had multiple organ failure, and 10 patients were with stress ulcer bleeding. Conclusion For patients with severe multiple trauma, a detailed inquiry and careful physical examination should be taken after admissions. Take a comprehensive understanding of the formation of the disease. Make a accurate and timely assessment of injury, take early implementation of the treatment for the major organ damage in order to improve the success rate of rescue. For abdominal injuries, we should focus on observation of the existence of liver and spleen rupture or contusion and other intestinal disease to avoid misdiagnosis.