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目的探讨多发伤的诊断方法和治疗措施。方法回顾性分析我科4年间收治的520例多发伤病人的临床资料。本组手术治疗的502例(96.5%),非手术治疗的18例(3.5%)。手术方法为颅内血肿清除术(20.1%)、膈修补(8.4%)、心脏修补(1.4%)、肺修补或切除(5.2%)、支气管吻合或修补(0.8%)、脾切除或修补(28.5%)、肝修补或切除(17.7%)、胰切除或内外引流(0.4%)、胆道修复引流(0.8%)、胃肠修补(4.8%)、肾修补或切除(4.4%)、膀胱修补造口(1.8%)、输尿管吻合(0.4%)、腹内血管修补或结扎(7.4%)和四肢骨折固定术(48.6%)。结果本组抢救成功452例(86.92%),死亡共68例(13.1%),其中,24h内手术治疗的459例中死亡32例(6.9%),创伤24h后手术治疗的43例中死亡26例(60.5%),非手术治疗的18例中死亡10例(55.5%)。24h内手术治疗的死亡率较非手术治疗或24h后治疗的死亡率明显降低(P<0.01)。结论抓紧创伤急救的“黄金时间”是抢救成功的关键,诊断治疗是否及时准确,往往比伤情本身更影响生存率。
Objective To investigate the diagnosis and treatment of multiple trauma. Methods The clinical data of 520 patients with multiple trauma admitted in our department for 4 years were retrospectively analyzed. The group of surgical treatment of 502 cases (96.5%), non-surgical treatment of 18 cases (3.5%). Surgical procedures included intracranial hematoma (20.1%), phrenic repair (8.4%), cardiac repair (1.4%), lung repair or resection (5.2%), bronchial anastomosis or repair (0.8%), splenectomy or repair 28.5%), liver repair or resection (17.7%), pancreatic resection or internal or external drainage (0.4%), biliary drainage (0.8%), gastrointestinal repair (4.8%), kidney repair or resection Ostomy (1.8%), ureteral anastomosis (0.4%), intra-abdominal vascular repair or ligation (7.4%) and extremity fracture fixation (48.6%). Results 452 cases (86.92%) were successful in the rescue and 68 cases (13.1%) died. Among 459 cases, 24 cases died of operation within 24 hours (6.9%), and 43 cases died of operation 24h after trauma Cases (60.5%), non-surgical treatment of 18 cases of death in 10 cases (55.5%). The mortality rate of surgical treatment within 24h was significantly lower than that of non-surgical treatment or after 24h treatment (P <0.01). Conclusion Pay close attention to trauma emergency “prime time” is the key to the success of the rescue, diagnosis and treatment is timely and accurate, often more than the injury itself affect the survival rate.