CAJ | 학술논문

目的评价严重骨盆骨折合并多发伤的早期急诊流程. 方法选择2007年1月-2011年5月收治113例严重骨盆骨折合并多发伤患者,其中2007年1月- 2008年5月(建立创伤团队前)收治组26例,2008年6月- 2011年5月(建立创伤团队后)收治组87例,比较建立创伤团队前、后不同阶段患者的急诊死亡率,并分析年龄、性别、ISS评分、骨折类型、受伤机制、转运时间、合并伤数量、初始血压、初始血红蛋白和输血量与死亡的关系. 结果建立创伤团队后患者的死亡率为23％,显著低于以前阶段死亡率46％,且死亡率与ISS评分和有两个部位以上合并伤呈显著相关性,而与年龄、性别、骨折类型、受伤机制、转运时间、初始血压和初始血红蛋白以及输血量无关.结论采用基于创伤团队的规范化流程可以有效处理严重骨盆骨折合并多发伤的患者,并可以降低死亡率.
목적 평개엄중골분골절합병다발상적조기급진류정. 방법 선택2007년1월-2011년5월수치113례엄중골분골절합병다발상환자,기중2007년1월- 2008년5월(건립창상단대전)수치조26례,2008년6월- 2011년5월(건립창상단대후)수치조87례,비교건립창상단대전、후불동계단환자적급진사망솔,병분석년령、성별、ISS평분、골절류형、수상궤제、전운시간、합병상수량、초시혈압、초시혈홍단백화수혈량여사망적관계. 결과 건립창상단대후환자적사망솔위23％,현저저우이전계단사망솔46％,차사망솔여ISS평분화유량개부위이상합병상정현저상관성,이여년령、성별、골절류형、수상궤제、전운시간、초시혈압화초시혈홍단백이급수혈량무관.결론 채용기우창상단대적규범화류정가이유효처리엄중골분골절합병다발상적환자,병가이강저사망솔.
Objective To evaluate the early emergency management process for severe pelvic fractures combined with multiple trauma. Methods The study involved 113 patients with severe pelvic fractures combined with multiple trauma treated from January 2007 to May 2011.The patients were divided into two groups,ie,before trauma team establishment (26 patients treated from January 2007 to May 2008) and after trauma team establishment (87 patients treated from June 2008 to May 2011 ) in accordance with the establishment period of trauma team in June 2008.The mortality was compared before and after application of trauma-team-based algorithm with damage control resuscitation,external fixation and angiographic embolization.Variables including age and gender distribution,ISS score,injury type and mechanism,transportation time,associated injury number,initial systolic pressure hemoglobin and blood transfusion were analyzed for study of their relation with mortality. Results After trauma team establishment,the mortality (23％) was significantly lower than before trauma team establishment (46％).The mortality showed significant relation to ISSN score and over two regions of associated injury,but showed no correlation with age and gender distribution,injury type and mechanism,transportation time initial systolic pressure hemoglobin,and blood transfusion. Conclusion The application of trauma team is effective in treatment of severe pelvic fractures combined with multiple trauma and can decrease the mortality.