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目的探讨多发性创伤的临床特点、诊断与救治方法,提高救治成功率,减少漏诊和误诊。方法对自2010年1月至2012年6月,经急诊救治的165例多发性创伤伤员的临床资料进行回顾性分析。结果交通事故伤115例(69.70%),高空坠落伤43例(26.06%),斗殴伤7例(4.24%)。ISS评分<16分54例,16≤ISS<25分71例,≥25分40例。治愈148例(89.70%);死亡17例(10.30%),其中死于脑疝6例,失血性休克死亡8例,多器官功能障碍(MODS)死亡2例,心包填塞死亡1例。受伤30 min内就诊死亡2例,30 min～1 h就诊死亡5例,>1 h就诊死亡10例。结论 (1)多发性创伤对机体损害程度重,救治难度大,死亡率高;(2)创伤性休克和颅脑外伤是主要致死原因;(3)应加强创伤急诊体系建设,实现多学科协同合作,提高救治的成功率。
Objective To investigate the clinical features, diagnosis and treatment of multiple trauma, improve the success rate of treatment and reduce the missed diagnosis and misdiagnosis. Methods From January 2010 to June 2012, the clinical data of 165 cases of multiple traumatic casualties treated by emergency department were analyzed retrospectively. Results 115 cases of traffic accidents (69.70%), 43 cases of falling injuries (26.06%) and 7 cases (4.24%) of injuries. ISS score <16 points in 54 cases, 16≤ISS <25 points in 71 cases, ≥ 25 points in 40 cases. 148 cases (89.70%) were cured, 17 died (10.30%), 6 died of herniation, 8 died of hemorrhagic shock, 2 died of multiple organ dysfunction (MODS) and 1 died of pericardial stuffing. Two patients died within 30 min after injury, 5 patients died within 30 min to 1 h, and 10 patients died within 1 h. Conclusions (1) Multiple traumatic injuries have a great degree of damage to the body, which is difficult to treat and have high mortality rate. (2) Traumatic shock and craniocerebral trauma are the main causes of death. (3) The construction of trauma emergency system should be strengthened to achieve multidisciplinary cooperation Cooperation, improve the success rate of treatment.