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目的探讨严重多发伤患者的临床救治方法及原则。方法采集2003年1月-2010年9月SICU收住的严重多发伤患者的临床资料,并对其治疗过程进行回顾性分析。结果本组患者均符合严重多发伤的诊断标准(ISS)≥16分,其中16～20分65例,21～30分79例,31～40分67例,41～50分28例,≥51分12例。251例患者中,治愈224例,抢救成功率89.24%;死亡27例,病死率10.76%。死亡原因:重型颅脑损伤19例,多器官功能衰竭4例,失血性休克3例,DIC 1例。结论创伤早期收住SICU行加强监护抢救、有效的液体复苏、采用损伤控制外科手术止血、术后行重要脏器的严密监测与支持、及时防治感染并发症等是抢救成功的关键。
Objective To investigate the methods and principles of clinical treatment in patients with severe multiple trauma. Methods The clinical data of patients with severe multiple trauma admitted to SICU from January 2003 to September 2010 were collected and retrospectively analyzed. Results The patients were all eligible for the diagnostic criteria of severe multiple trauma (ISS) ≥16, among which 16 to 20 were 65, 21 to 30, 79, 31 to 40, 67, 41 to 50, and 28 were ≥51 Divided into 12 cases. Among 251 patients, 224 cases were cured, the success rate of rescue was 89.24%, 27 cases died and the case fatality rate was 10.76%. Causes of death: severe craniocerebral injury in 19 cases, multiple organ failure in 4 cases, hemorrhagic shock in 3 cases, DIC in 1 case. Conclusions The key to the successful rescue is to strengthen the emergency rescue, effective liquid resuscitation, injury control and surgery to stop bleeding, close monitoring and support of important organs after operation, and timely prevention and treatment of infection complications.