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目的:探讨妊娠期严重创伤的特点和救治方法。方法:对47例妊娠期严重创伤患者的临床资料进行总结分析,按救治方式的不同将患者分为多科会诊救治组(n=16例)和急救创伤团队救治组(n=31例),探讨不同救治方式对患者的疗效。结果:急救创伤团队救治组死亡3例(9.7%),ISS评分为(35.9±3.9)分,平均入院至手术开始时间为(58.0±6.0)min,并发症发生率为41.9%,平均住院时间为(28.0±4.0)d;多科会诊救治组死亡6例(37.5%),ISS评分为(37.1±3.6)分,平均入院至手术开始时间为(137.0±11.0)min,并发症发生率为68.8%,平均住院时间为(39.0±3.0)d。2组患者的ISS评分差异无统计学意义(P>0.05),但在死亡率、入院至手术开始时间、并发症发生率及住院时间方面差异有统计学意义(P<0.05或P<0.01)。结论:专业的急救创伤团队,早期液体复苏和原发伤的确定性手术治疗以及微创技术和理念的应用能最大限度地提高妊娠期严重创伤患者的救治成功率。
Objective: To investigate the characteristics and treatment of severe trauma during pregnancy. Methods: The clinical data of 47 cases of severe traumatic pregnancy were summarized and analyzed. According to the way of treatment, the patients were divided into multi-disciplinary group (n = 16) and emergency group (n = 31) To explore the efficacy of different treatment methods on patients. Results: There were 3 deaths (9.7%) in the emergency trauma team and 35.9 ± 3.9 points in the ISS score. The average hospitalization time was (58.0 ± 6.0) min and the complication rate was 41.9% (37.0%), and the mean ISS score was (37.1 ± 3.6) points. The mean hospital admission time was (137.0 ± 11.0) min and the complication rate was 68.8%, the average hospital stay was (39.0 ± 3.0) d. There was no significant difference in ISS score between the two groups (P> 0.05), but there was a significant difference in the mortality rate, the time from admission to surgery, the complication rate and hospital stay (P <0.05 or P <0.01) . CONCLUSIONS: The use of specialized first-aid trauma teams, definitive surgical treatment of early fluid resuscitation and primary injury, and minimally invasive techniques and concepts can maximize the success rate of treatment for patients with severe trauma during pregnancy.