262例严重多发性创伤患者救治的临床效果研究

目的探讨严重多发伤的临床特点及救治措施。方法对2004年1月～2007年12月本院救治的262例严重多发伤进行回顾性分析。结果本组病例的创伤严重度评分（ISS）〉16，平均23．5±6．2。急诊手术164例次，其中84例在1次麻醉下分组同台完成了2个以上部位的手术。重症监护病房（ICU）平均住院（23．8±5．2）d。临床治愈205例（78．2％1，致残39例（14．9％），死亡18例（6．9％）。结论对严重创伤患者，在复苏同时应尽快采用简单省时的手术控制出血和污染，主动实施损伤控制性手术（DCO）策略，可提高严重创伤的抢救成功率。

Management of severe multiple trauma:analysis of 262 patients

Object i ve To discuss the clinical features and treatment of severe multiple trauma. Methods The clinical data of 262 patients with multiple trauma admitted Jan 2004 to Dec 2007 were analyzed retrospectively. Results The injury severity scores of these patients were all 〉 16, with an average value of （23.5 ＋ 8.2）. 164 patients underwent immediate emergent operations, among them 84 patients received two or three operations on different anatomical regions under a single anesthesia. The mean length of stay in the intensive care unit （ICU） was （23.8 ＋ 5.2） days. 205 cases （78.2%） had a good recovery, 39 cases （14.9%） became disabled, and 18 cases （6.9%） died. Conclusion For serious trauma patients, control of bleeding and pollution, emergency operation, and anabiosis must be undertaken. The damage control operation （DCO） strategy can improve the success rate of treatment of severe multiple trauma.