摘要
目的 分析不同年龄组严重创伤的临床特征和救治结果 ,以提高严重创伤的急诊救治水平。 方法 1995年 1月～ 2 0 0 1年 1月 6年间共救治严重创伤患者 12 80例 ,分为儿童组 (<13岁 ) 70例 ,青年组 (13～ 45岁 ) 970例 ,中年组 (45～ 65岁 ) 146例 ,老年组 (≥ 65岁 ) 94例。入选病例按损伤严重程度评分 (ISS)标准进行评估 ,所有患者ISS≥ 16。 结果 各组男性患者均多于女性 ,青年组和中年组男性严重创伤比例显著高于儿童组和老年组 (P <0 .0 1)。交通伤是首要致伤原因 ,第二位致伤原因坠落伤在儿童组和青年组、锐器伤在青年组和中年组、跌伤在老年组显著增高 (P <0 .0 1)。儿童组和老年组颅脑损伤、儿童组和青年组腹部损伤、青年组四肢和 (或 )脊柱损伤显著增高 (P =0 .0 0 0 0 )。创伤的发生率儿童组在秋季、青年组在夏季、老年组在冬季增高 ,儿童组在冬季则显著降低 (P <0 .0 1)。总病死率为 17.1% (2 19 12 80 ) ,老年组创伤 <2 4h病死率 (3 6.2 % ,3 4 94)较≥ 2 4h病死率 (8.5 % ,8 94)显著增高 (P =0 .0 0 0 )。多发伤生存患者的ISS值各组差异无显著性意义 (P >0 .0 5 ) ,老年组死亡患者ISS值与其他各组比较 ,差异有显著性意义 (P <0 .0 5 )。 结论 各年龄组严重创伤患者在性别构成、致伤原?
Objective To study the clinical characteristics and outcomes of severe trauma in patients at various ages in emergency in order to make further improvement in corresponding treatment. Methods All of 1 280 cases with severe trauma admitted in the Emergency Department from January 1995 to January 2001 were divided into 4 groups: (1) adolescent group (Group A, <13 years old, n =70), (2) youth group (Group B, 13 45 years old, n =970), (3) middle age group (Group C, 45 65 years old, n =146) and (4) elderly group (Group D, ≥65 years old, n =94). All the cases were evaluated by injury severity score (ISS), which was ≥16 in all cases. Results The incidence of severe trauma in the males in 4 groups was all higher than that in the females. It was sinificantly higher in Group B and Group C than that of other groups ( P <0.01). Traffic accident was the leading cause of injury. However, injury by fall from height as the second injury cause was significantly increased in Group A and Group B, penetrating and cutting injury in Group B and Group C, slip fall injury in Group D ( P <0.01). Head injury was enhanced markedly in Group A and Group D, abdominal injury in Group A and Group B, extremities injury and/or spinal injury in Group B ( P =0.000 0). The occurrence rate of trauma in Group A was increased in autumn, that in Group B in summer and that in Group D in winter. But occurrence rate of trauma in Group A in winter was decreased markedly ( P < 0.01 ). The total mortality was 17.1% (219/1 280). The mortality within 24 hours (36.2%, 34/94) was significantly higher than that over 24 hours (8.5%, 8/94) in Group D ( P =0.000). The ISS of survived patients with multitrauma in each group showed no obvious difference ( P >0.05). The ISS of dead patients in Group D was significantly higher compared with other groups ( P <0.05). Conclusions There are different characteristics in patients at various ages uopon sex, injury causes, injury sites and seasonal occurrence of injury. The mortality in the elderly is significantly increased following severe trauma.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2003年第2期107-110,共4页
Chinese Journal of Trauma
关键词
损伤严重程序评分
急诊
年龄
损伤
救治
Wounds and injuries
Injury severity score
Emergency service, hospital
Various ages
