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急诊多发性创伤的急救治疗及临床疗效评估(1)
http://www.100md.com 2017年8月5日 《中外医疗》 2017年第22期
     [摘要] 目的 研究并分析治疗急诊多发性创伤患者时使用手术治疗的效果。方法 整群收集该院2016年1月—2017年3月急诊多发性创伤患者共134例,根据其临床资料分为对照组(63例)和观察组(71例),对照组接受择期手术治疗,观察组接受急诊手术治疗,将两组出血量、并发症发生率进行观察和对比。结果 观察组的伤口出血量为(92.41±26.57)mL,显著低于对照组的(363.28±53.06)mL(t=37.993,P=0.001);觀察组的消化道出血量为(163.73±27.38)mL,显著低于对照组的(268.32±40.09)mL,(t=17.800,P=0.001);观察组的颅内出血量为(19.72±3.69)mL,显著低于对照组的(36.35±4.48)mL,(t=23.533,P=0.001);观察组的并发症发生率为4.23%,显著低于对照组的15.87%,(χ2=5.170,P=0.023)。 结论 在急诊多发性创伤患者的治疗过程中,急诊手术治疗能够显著降低患者的出血量,减少再出血的发生风险,且并发症少,安全隐患小,值得推广应用。

    [关键词] 急诊多发性创伤;手术治疗;出血量;并发症;治疗效果

    [中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2017)08(a)-0077-03

    [Abstracts] Objective This paper tries to study and analyze the effectiveness of surgical treatment in patients with multiple traumas. Methods 134 cases of patients with multiple traumas in this hospital from January 2016 to March 2017 were cluster selected and randomly divided into the control group (63 cases) and the observation group (71 cases) according to the clinical data. The control group underwent elective surgical treatment, the observation group received emergency surgical treatment, and the hemorrhage and complication rate of the two groups were observed and compared. Results Wound bleeding of the observation group was (92.41±26.57) mL, significantly lower than the control group of (363.28±53.06) mL,(t=37.993, P=0.001); the gastrointestinal hemorrhage of the observation group was (163.73±27.38) mL, significantly lower than the control group of (268.32±40.09) mL,(t=17.800, P=0.001); intracranial hemorrhage of the observation group was(19.72±3.69) mL, significantly lower than the control group of (36.35±4.48) mL,(t=23.533, P=0.001); The complications of observation group was 4.23%, significantly lower than the control group of 15.87%,(χ2=5.170, P=0.023). Conclusion In the emergency treatment of patients with multiple traumas, emergency operation can significantly reduce the patient’s blood loss, reduce the risk of rebleeding and complications, hidden safety troubles, so it is worth popularization and application.

    [Key words] Emergency multiple traumas; Surgical treatment; Bleeding amount; Complications; Treatment effect

    多发性创伤指的是在同一个致伤因素的影响及作用下,人体中两个以上的器官或解剖部位同时或者相继受到创伤,并且其中一处及以上创伤危及了患者生命,或者引发创伤性休克[1-2]。相关的研究报道称,多发性创伤患者通常伤情严重,且病情复杂,伤情变化十分迅速,并发症的发生风险高,而且容易出现误诊和漏诊,一旦处理措施不当很可能导致患者死亡[3-4]。在该次研究中,对2016年1月—2017年3月该院134例急诊多发性创伤患者的临床资料进行了回顾性分析,现报道如下。

    1 资料与方法

    1.1 一般资料

    整群选取该院急诊多发性创伤患者共134例,根据其临床资料分为对照组(63例)和观察组(71例),其中,对照组男39例,女24例;年龄在20~65岁之间,平均年龄为(43.1±5.9)岁;骨折部位包括:30例多发性肋骨骨折,24例上肢骨折,9例盆骨骨折;受伤原因:39例交通事故伤,20例高处坠落伤,4例暴力击打伤;11例患者合并休克。观察组男45例,女26例;年龄在20~63岁之间,平均年龄为(43.0±5.8)岁;骨折部位包括:30例多发性肋骨骨折,28例上肢骨折,13例盆骨骨折;受伤原因:48例交通事故伤,20例高处坠落伤,3例暴力击打伤;15例患者合并休克。两组患者基线资料均差异无统计学意义(P>0.05),存在可比性。, 百拇医药(吴召宾)
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