CAJ | 학술논문

目的探讨重型、特重型颅脑创伤伴有多发伤漏诊规律和防治策略. 方法收集2000年1月-2007年8月收治的432例符合重型、特重型颅脑创伤合并多发伤(ISS≥20分)诊断标准患者的临床资料并对其进行回顾性分析,将其分为漏诊组和尤漏诊组,对ISS、GCS、漏诊的部位、时间、预后进行相关性分析. 结果 432例患者中有54例漏诊,ISS为(42.97±10.94)分,与无漏诊组比较,差异有统计学意义(P<0.05).漏诊组GCS≤8分的患者比例高于非漏诊组(P<0.05). 结论迅速准确的程序化伤情判断、贯穿生命第一原则的全面体检、重点辅查及动态复查是防止漏诊、提高重型颅创伤合并多发伤生存率并减少致残率的有效措施.
목적 탐토중형、특중형로뇌창상반유다발상루진규률화방치책략. 방법 수집2000년1월-2007년8월수치적432례부합중형、특중형로뇌창상합병다발상(ISS≥20분)진단표준환자적림상자료병대기진행회고성분석,장기분위루진조화우루진조,대ISS、GCS、루진적부위、시간、예후진행상관성분석. 결과 432례환자중유54례루진,ISS위(42.97±10.94)분,여무루진조비교,차이유통계학의의(P<0.05).루진조GCS≤8분적환자비례고우비루진조(P<0.05). 결론 신속준학적정서화상정판단、관천생명제일원칙적전면체검、중점보사급동태복사시방지루진、제고중형로창상합병다발상생존솔병감소치잔솔적유효조시.
Objective To investigate the strategies of reducing the incidence of missed diagnosis of severe traumatic brain injuries combined with multiple trauma. Methods Data of 432 patients with severe traumatic brain injuries and multiple trauma (ISS≥20) from January 2000 to August 2007 were analyzed retrospectively. All patients were divided into missed diagnosis group (MD group, n =54) and non-missed diagnosis group (NMD group, n =378) for correlation analysis on ISS, GCS, anatomical locations of the missed diagnosis, the time of delayed diagnosis and the prognosis. Results ISS was (42.97±10.94) points in MD group, with statistical difference compared with NMD group (P < 0.05). The patients with GCS≤8 in MD group was more than those in NMD group (P < 0.05). Conclusions It is effective to prevent missed diagnosis and improve the survival of patients with severe traumatic brain injuries combined with multiple trauma by judging injury severity quickly and precisely based on the principle of "life first" and repeated and systemic physical examination.