CAJ | 학술논문

目的探讨ICU治疗严重多发伤的伤情标准及意义. 方法通过分析“中华创伤数据库”收录的解放军第一一七医院交通伤急救中心2006-2012年收治的64例(ISS≥20分)非死亡严重多发伤患者资料,比较ICU救治组和非ICU救治组在创伤评分、并发症、功能预后及医疗成本等方面的差异. 结果两组患者ISS与新损伤严重度评分(new ISS,NISS)差异无统计学意义,但GCS和修正创伤记分(revised trauma score,RTS)差异有统计学意义(P＜0.05);两组患者住院天数和医疗费用等差异无统计学意义,但发生并发症例数和出院时功能独立性评定(functional independence measure,FIM)差异有统计学意义(P＜0.05).非ICU救治组发生并发症的可能性是ICU救治组的2.96倍.ICU救治组FIM为10.11 ±2.10,显著高于非ICU救治组(8.67 ±2.99) (P ＜0.05).结论 ISS≥20分的严重多发伤患者进入ICU治疗有利于降低并发症发生率.
목적 탐토ICU치료엄중다발상적상정표준급의의. 방법 통과분석“중화창상수거고”수록적해방군제일일칠의원교통상급구중심2006-2012년수치적64례(ISS≥20분)비사망엄중다발상환자자료,비교ICU구치조화비ICU구치조재창상평분、병발증、공능예후급의료성본등방면적차이. 결과 량조환자ISS여신손상엄중도평분(new ISS,NISS)차이무통계학의의,단GCS화수정창상기분(revised trauma score,RTS)차이유통계학의의(P＜0.05);량조환자주원천수화의료비용등차이무통계학의의,단발생병발증례수화출원시공능독립성평정(functional independence measure,FIM)차이유통계학의의(P＜0.05).비ICU구치조발생병발증적가능성시ICU구치조적2.96배.ICU구치조FIM위10.11 ±2.10,현저고우비ICU구치조(8.67 ±2.99) (P ＜0.05).결론 ISS≥20분적엄중다발상환자진입ICU치료유리우강저병발증발생솔.
Objective To investigate the criteria and significance for management of severe multiple trauma in the intensive care unit (ICU).Methods Data of 64 patients with non-fatal severe multi-trauma (ISS≥20) treated in the First Aid Center for Traffic Injuries in 117th Hospital of PLA between 2006-2012 documented in China Trauma Database were analyzed.Differences in trauma scoring,complications,functional prognosis and medical cost were analyzed between ICU and non-ICU patients.Results There were statistical differences for GCS and revised trauma score (RTS) between ICU patients and non-ICU patients (P ＜ 0.05),but the differences were insignificant for ISS and new ISS (NISS).Likewise,the differences were significant for complication incidence and functional independence measure (FIM) on discharge (P ＜ 0.05),but not in the length of hospital stay and medical cost.Complication incidence of non-ICU patients was 2.96 times that of ICU patients.FIM of ICU patients scored 10.11 ± 2.10,far higher than that of non-ICU patients (P ＜ 0.05).Conclusion For severe multiple trauma patients with ISS≥20,the admission to the ICU is helpful for reduction of the complication rate.