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目的探讨外科重症监护室(ICU)在多发伤监护及治疗上的作用。方法总结2005年1月至2009年7月接受ICU监护和治疗的145例严重多发伤患者的临床资料,分析严重多发伤在ICU处理中的几个关键问题如复苏、外科病情变化的监护及重要脏器的功能支持;并提出预防及治疗对策。结果本组发生急性呼吸窘迫综合征(ARDS)14例(9.66%),多器官功能障碍综合征(MODS)17例(11.72%),应激性溃疡伴出血38例(26.2%);其治愈率分别为71.42%(10/14)、47.06%(8/17)、84.21%(32/38)。全组总存活率为90.34%(131/145),病死率为9.66%(14/145)。结论在ICU能对一些危重患者可能发生的器官、系统衰竭的征象进行及时、系统、连续地严密监测和处理,以防止致命性并发症的出现,从而为专科治疗赢得宝贵时间。ICU治疗在严重多发伤的抢救治疗过程中具有非常重要的作用;强调严重多发伤抢救建立在重症监护平台上的多科室共同协作的抢救模式。
Objective To investigate the role of surgical intensive care unit (ICU) in the care and treatment of multiple trauma. Methods From January 2005 to July 2009 in ICU custody and treatment of 145 cases of severe traumatic patients clinical data analysis of severe multiple trauma in the ICU treatment of several key issues such as recovery, surgical condition monitoring changes and important Organ function support; and proposing prevention and treatment measures. Results There were 14 cases (9.66%) of acute respiratory distress syndrome (ARDS), 17 cases (11.72%) of multiple organ dysfunction syndrome (MODS) and 38 (26.2%) cases of stress ulcer with hemorrhage. The rates were 71.42% (10/14), 47.06% (8/17) and 84.21% (32/38), respectively. The overall survival rate was 90.34% (131/145), the case fatality rate was 9.66% (14/145). Conclusions The ICU can monitor the organ and systemic failure signs that may occur in some critically ill patients in a timely, systematic and continuous manner to prevent the occurrence of fatal complications and thus win valuable time for specialist treatment. ICU treatment plays a very important role in the treatment of severe multiple traumatic injuries. It emphasizes that severe multiple trauma rescues multidisciplinary rescue modes based on intensive care platform.