CAJ | 학술논문

【目的】探讨骨盆骨折及其合并伤的临床预后以及引起死亡的相关危险因素分析。【方法】收集2010年1月至2014年1月在本院就诊的360例骨盆骨折患者的临床资料，对患者的临床预后及其相关死亡危险因素进行回归分析。【结果】交通事故是引起骨盆骨折的最常见原因之一，其总的病死率为16．4％（59／360），包括早期（＜24 h）因严重失血性休克致死24例，中晚期致死35例。经Fisher精确概率法分析显示：患者年龄、骨折分型、首个24 h输血量、损伤严重度分数（ISS）、改进创伤评分（RTS）以及是否继发感染是骨盆骨折死亡危险因素。Logistic回归结果显示：首个24 h输血量以及RTS（≤8）是早期死亡的危险因素；年龄以及RTS（≤8）是晚期死亡的危险因素。【结论】骨盆骨折病死率仍然很高，预后较差；早期积极有效的抗休克治疗、维持血流动力学稳定以及适时手术治疗能改善其临床预后。
【목적】탐토골분골절급기합병상적림상예후이급인기사망적상관위험인소분석。【방법】수집2010년1월지2014년1월재본원취진적360례골분골절환자적림상자료，대환자적림상예후급기상관사망위험인소진행회귀분석。【결과】교통사고시인기골분골절적최상견원인지일，기총적병사솔위16．4％（59／360），포괄조기（＜24 h）인엄중실혈성휴극치사24례，중만기치사35례。경Fisher정학개솔법분석현시：환자년령、골절분형、수개24 h수혈량、손상엄중도분수（ISS）、개진창상평분（RTS）이급시부계발감염시골분골절사망위험인소。Logistic회귀결과현시：수개24 h수혈량이급RTS（≤8）시조기사망적위험인소；년령이급RTS（≤8）시만기사망적위험인소。【결론】골분골절병사솔잉연흔고，예후교차；조기적겁유효적항휴극치료、유지혈류동역학은정이급괄시수술치료능개선기림상예후。
[Objective] To explore the clinical prognosis and risk factors for mortality for patients with pel‐vic fracture .[Methods] The clinical data of 360 patients with pelvic fracture from 2010 January to 2014 Janu‐ary were analyzed .Fisher's exact test and Logistic regression analysis were performed for identifying the risk factors for clinical prognosis and mortality .[Results] Traffic accident was one of the most common causes of pelvic fracture .The overall mortality was up to 16 .4% .And 24 cases died of serious hemorrhagic shock in early 24 h and another 35 died later .Fisher's exact test showed that age ,fracture classification ,blood transfu‐sion for the first 24 h ,injury severity score (ISS) ,revised trauma score (RTS) and secondary infection were the risk factors for mortality .Logistic regression analysis indicated that blood transfusion for the first 24h and RTS (≤8) were two risk factors for early mortality while advanced age and RTS (≤8) were two risk factors for later mortality .[Conclusion]The mortality of pelvic fracture remains high and the prognosis is poor .Early treatment for shock ,maintaining hemodynamics and timely operation can improve the prognosis greatly .