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ICU在严重多发伤救治中的作用 被引量:12

Role of intensive care unit in treatment of severe multiple trauma
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摘要 目的探讨ICU治疗严重多发伤的伤情标准及意义。方法通过分析“中华创伤数据库”收录的解放军第一一七医院交通伤急救中心2006—2012年收治的64例(ISS/〉20分)非死亡严重多发伤患者资料,比较ICU救治组和非ICU救治组在创伤评分、并发症、功能预后及医疗成本等方面的差异。结果两组患者ISS与新损伤严重度评分(newISS,NISS)差异无统计学意义,但GCS和修正创伤记分(revised traumascore,RTS)差异有统计学意义(P〈0.05);两组患者住院天数和医疗费用等差异无统计学意义,但发生并发症例数和出院时功能独立性评定(functional independence measure,FIM)差异有统计学意义(P〈0.05)。非ICU救治组发生并发症的可能性是ICU救治组的2.96倍。ICU救治组FIM为10.11±2.10,显著高于非ICU救治组(8.67±2.99)(P〈0.05)。结论ISS/〉20分的严重多发伤患者进入ICU治疗有利于降低并发症发生率。 Objective To investigate the criteria and significance for management of severe mul- tiple trauma in the intensive care unit ( ICU ). Methods Data of 64 patients with non-fatal severe multi-trauma (ISS≥20) treated in the First Aid Center for Traffic Injuries in 117th Hospital of PLA be- tween 2006-2012 documented in China Trauma Database were analyzed. Differences in trauma scoring, complications, functional prognosis and medical cost were analyzed between ICU and non-ICU patients. Results There were statistical differences for GCS and revised trauma score (RTS) between ICU pa- tients and non-ICU patients ( P 〈 0.05 ) , but the differences were insignificant for ISS and new ISS (NISS). Likewise, the differences were significant for complication incidence and functional independ- ence measure (FIM) on discharge ( P 〈 0.05 ), but not in the length of hospital stay and medical cost. Complication incidence of non-ICU patients was 2.96 times that of ICU patients. FIM of ICU patients scored 10.11 ±2.10, far higher than that of non-ICU patients (P 〈 0.05 ). Conclusion For severe multiple trauma patients with ISS≥20, the admission to the ICU is helpful for reduction of the complica- tion rate.
出处 《中华创伤杂志》 CAS CSCD 北大核心 2013年第11期1091-1093,共3页 Chinese Journal of Trauma
基金 卫生部卫生公益性行业科研专项基金资助项目(201002014)
关键词 多处创伤 数据库 重症监护室 Muhiple trauma Database Intensive care unit
作者简介 施建国(电话:0571—87340801,Email:rmelvin@163.com) 通信作者:姚远,电话:0571—87340845,Email:bluesir.yao@gmail.com
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