中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2009年
4期
372-375
,共4页
创伤评分%创伤%急诊救治
創傷評分%創傷%急診救治
창상평분%창상%급진구치
Trauma score%Trauma%Emergency treatment
目的 创伤评分(trauma score,TS)是根据患者的解剖、生理指标进行量化表达,对创伤进行综合判断,以便快速完成急诊接诊程序,提高救治质量,从而探讨,TS在创伤患者快速救治中的价值.方法 通过采用TS对上海交通大学附属第六人民医院金山分院的1568例创伤患者进入和离开急诊抢救室的创伤严重程度进行评估,同时进行必要影像学等检查和救治.结果 TS分值越低表示伤情越严重,但对以颅脑伤为主的伤员,TS敏感性差,仍以GCS评分更为有价值,本组1568例创伤患者入急诊抢救室时TS分值≥10分者1135例,占72.39%,＜10分者443例,占27.61%;经救治离开急诊室时,TS分值≥10分者1435例,占91.52%,＜10分者133例,占8.41%;两者比较差异均具有统计学意义(P＜0.01).TS分值越低,在救治中出现低血压、休克等严重并发症的发生率越高.液体需要与TS分值有明显相关性,TS分值越低,液体需要量越大.结论 TS使用简便快速,易掌握,能较好地反映创伤患者伤情,便于院前、急诊科医生尽早掌握伤情,尽快完成急诊接诊程序和采取有效救治措施.尤其对创伤、失血性休克患者,在受伤后"黄金1小时"内,迅速补充1500 mL以上液体十分必要.
目的 創傷評分(trauma score,TS)是根據患者的解剖、生理指標進行量化錶達,對創傷進行綜閤判斷,以便快速完成急診接診程序,提高救治質量,從而探討,TS在創傷患者快速救治中的價值.方法 通過採用TS對上海交通大學附屬第六人民醫院金山分院的1568例創傷患者進入和離開急診搶救室的創傷嚴重程度進行評估,同時進行必要影像學等檢查和救治.結果 TS分值越低錶示傷情越嚴重,但對以顱腦傷為主的傷員,TS敏感性差,仍以GCS評分更為有價值,本組1568例創傷患者入急診搶救室時TS分值≥10分者1135例,佔72.39%,＜10分者443例,佔27.61%;經救治離開急診室時,TS分值≥10分者1435例,佔91.52%,＜10分者133例,佔8.41%;兩者比較差異均具有統計學意義(P＜0.01).TS分值越低,在救治中齣現低血壓、休剋等嚴重併髮癥的髮生率越高.液體需要與TS分值有明顯相關性,TS分值越低,液體需要量越大.結論 TS使用簡便快速,易掌握,能較好地反映創傷患者傷情,便于院前、急診科醫生儘早掌握傷情,儘快完成急診接診程序和採取有效救治措施.尤其對創傷、失血性休剋患者,在受傷後"黃金1小時"內,迅速補充1500 mL以上液體十分必要.
목적 창상평분(trauma score,TS)시근거환자적해부、생리지표진행양화표체,대창상진행종합판단,이편쾌속완성급진접진정서,제고구치질량,종이탐토,TS재창상환자쾌속구치중적개치.방법 통과채용TS대상해교통대학부속제륙인민의원금산분원적1568례창상환자진입화리개급진창구실적창상엄중정도진행평고,동시진행필요영상학등검사화구치.결과 TS분치월저표시상정월엄중,단대이로뇌상위주적상원,TS민감성차,잉이GCS평분경위유개치,본조1568례창상환자입급진창구실시TS분치≥10분자1135례,점72.39%,＜10분자443례,점27.61%;경구치리개급진실시,TS분치≥10분자1435례,점91.52%,＜10분자133례,점8.41%;량자비교차이균구유통계학의의(P＜0.01).TS분치월저,재구치중출현저혈압、휴극등엄중병발증적발생솔월고.액체수요여TS분치유명현상관성,TS분치월저,액체수요량월대.결론 TS사용간편쾌속,역장악,능교호지반영창상환자상정,편우원전、급진과의생진조장악상정,진쾌완성급진접진정서화채취유효구치조시.우기대창상、실혈성휴극환자,재수상후"황금1소시"내,신속보충1500 mL이상액체십분필요.
Objective To explore the value of trauma seore(TS)in emergency care according to anatomy,physiological parameters of patients in order to improve the efficiency of emergency care.Method The injury severity of 1568 patients with trauma admitted to Emergency Department was assessed with TS,and complieations were recorded in Jinshan Branch of Sixth Municipal Hospital Affiliated Shanghai Jiaotong University.The interventions,monitoring and imaging examinations started immediately after admission.Results The lower the TS,the poorer the patient's condition.However,the sensitivity of TS was low in the patients with brain injury,whereas the Glasgow coma score (GCS)was more valuable.The patients with score of 10 or above accounted for 72.39% of patients while 27.61% patients had score of 10 or below.Alout 91.52%patients who had TS above 10 and 8.41% patients who had TS 10 or below survived and were discharged from Emergency Department(both P＜0.001).The patients with score of 10 or below had a higher rate of severe complications including hypotension,shock,abnormal respiration and cardiac arrest.The lower the TS,the larger the volume of fluid resuscitation reqired.Conclusions TS is an objective valuein assessing the seriousness of the oatient's condition,which can help doctors quickly deal with the injured patients.Rapid administration of more than 1500 mL of fluid,is especially necessary for the trauma patients with hemontlagic shock in the period of"golden one hour"after injury.
