摘要
目的 探讨不同年龄组严重多发伤患者的病情和预后特点，为进一步提高救治水平提供经验。方法回顾最近3a急诊ICU收治的年龄〉18周岁、创伤严重度评分（ISS）≥16分、ICU住院时间〉24h的146例严重多发伤患者的资料。根据年龄分为老年（≥60岁）、中年（40～59岁）和青年（18～39岁）三组，比较各组的一般情况、损伤严重度、急诊手术、继发感染、脏器功能不全、呼吸机使用时间、ICU住院时间和最终预后；比较各组治愈出院者的上述指标。结果各组的一般情况、致伤原因、损伤程度、急诊手术情况差异无显著性，但老年组的APACHEⅢ评分明显高于另两组；老年组入院24h的心率、中性粒细胞绝对值和动脉血氧分压低于另两组；各组继发感染、脏器功能不全、呼吸机使用时间、ICU住院时间比较差异无显著性，年龄越轻，预后越好；治愈出院者中以青年组损伤和病情最为严重。结论创伤时机体的影响随年龄增加而加重，预后明显变差，要特别重视老年创伤的救治，有必要建立专门的创伤救治体系。
Objective To analyze characters and prognosis of patients with severe multiple trauma from different age groups and to find out strategy for improvement of therapy. Methods The data of 146 severe multiple trauma patients admitted to emergency ICU in the past thee years, with age〉18 years, injury severity score （ISS）≥ 16 and ICU stay 〉 24 h, were retrospectively collected. Patients were divided into geriatric group （≥ 60 years）, middle-aged group （40～59 years）, and young group （ 18～39 years）. Demographic data, injury severity, emergency operation, acquired infection, development of multiple organ dysfunction, length of ventilation, length of stay in ICU, prognosis were compared among three groups. Those parameters were also analyzed in those survivors from different groups. Results There were no significant difference for demographic data, cause of injury, injury severity, emergency operation among three groups. Geriatric group had higher APACHEⅢ value and lower heart rate, neutrophil count, arterial partial pressure of oxygen at the first 24 h of admission than young and middle-aged group. The acquired infection, development of multiple organ dysfunction, length of ventilation and length of stay in ICU were not different among these groups. The younger groups had better prognosis. In survivors, those from young group had the highest injury severity. Conclusion Trauma had more serious effects on older patients, resulting in worse prognosis. More attention should be paid to the care of severe geriatric trauma and it＇ s of clinical significance to establish specialized trauma care system.
出处
《中国急救医学》
CAS
CSCD
北大核心
2006年第3期172-174,共3页
Chinese Journal of Critical Care Medicine
