| Objectives:Summarize the clinical feature that the serious pilosity of our academy injures the case through the System Analysis of grading of the wound, in order that it is chosen that this kind of patient's condition is assessed, treated, surgery opportunity and prognosis offer the preliminary basis on the clinic.Methods:Retrospective study, by January 2005-2010 12-month period in the Guangzhou University of Traditional Chinese Medicine, First Affiliated Hospital emergency room treated 90 patients with severe multiple injuries clinical data were recorded in patients with multiple injuries and general information about cause of injury and time, the incidence of complications, mortality, etc., according to ISS (injury severity score) score range compared to group analysis.Result:(1) The group of severe multiple trauma patients with a total of 90 patients successfully rescued the total 70 cases (77.8%),20 patients died (22.2%), all 36 cases of complications, including:SIRS 35例, MODS 24 cases, infection in 10 cases (4 cases of lung infection, kidney infection in 2, wound infection in 4 cases), upper gastrointestinal bleeding in 2 cases, ARDS 4例, DIC 6 cases; in this group age of severe multiple trauma cases are distributed in the 21-40 age range (62.2%); The main reason for injury accidents, falls injuries wounds, injury site focused on the head, chest, abdomen and limbs, and deaths are mainly internal injuries severe brain injuries to abdominal organs. (2)①by ISS scoring, death group case all distribution in ISS≥25 min interval, to 25-30 (80%) and the>35 min interval (20%); and the Group complications distribution no obvious differences, but in ISS high min section complications more serious;②blunt sexual injury and penetrating injury comparison Shi found blunt sexual injury group mortality higher, has significantly sexual differences, but two group ISS scoring no statistics differences;③chest abdominal group and the head injury mainly of case respectively for survival group and death group of scoring comparison, found no statistics differences;④on head injury mainly of case for MHIPS scoring, survival group and death group case distribution has significantly sexual differences, and death group scoring obvious below survival group, this scoring system more ISS scoring system more effective forecast merged head injury case of condition and the prognosis;⑤this group case purposes of in the large operation all distribution AIS scoring≥3 min of case, death case is all in AIS≥4 min of case (AIS=5 case for 14 cases, AIS=4 case for 6 cases), operation case accounted for score within all case of proportion has obvious differences.Conclusion:(1)ISS can appraise condition and prognosis that the serious pilosity injures effectively while grading. (2)The death case concentrates on ISS and is greater than or equal to the block of 25, and the complication incidence also increases, with ISS=It is wounded and comparatively rational for 25 to define the serious pilosity. (3)There is influence on that it is assessed to injure properties. (4)ISS grades and exists insufficiently in amalgamating condition and prognosis that the cranium brain injure the case, uses the new score system wounded to the serious pilosity that amalgamates cranium brain injury--MHIPS system of grading, it is more rational to evaluate condition. (5) AIS-ISS grades in the course, can guide the implementation of the operation scheme according to AIS situation of grading.
|
PDF Full Text Request