老年严重多发伤的临床特点及相关的急救措施

发布时间：2018-04-20 02:16

本文选题：严重多发伤 + 急救措施　；参考：《中国老年学杂志》2016年06期

【摘要】：目的探讨老年严重多发伤的临床特点以及相关的急救措施。方法 2009年1月至2014年1月对60例急诊外科接受急救的老年多发伤患者和50例青中年严重多发伤患者的临床资料和预后情况进行了对比分析,总结老年严重多发伤的临床特点,并针对性地实施急救措施。结果老年组患者中颅脑损伤所占比例最高,明显高于青中年组的颅脑损伤比例;而青中年组的四肢或脊柱损伤发生比例最高,且明显高于老年组(χ2=3.95、4.02,P0.05)。老年组致伤原因:交通伤26例(43.33%),跌倒20例(33.33%),坠落伤12例(20.00%),塌方2例(3.33%)。青中年组致伤原因:交通伤28例(56.00%),跌倒5例(10.00%),械斗12例(24.00%),塌方1例(2.00%),坠落伤4例(8.00%)。两组患者的性别、损伤部位数、简明损伤定级与损伤严重度计分(AIS90-ISS)评分及受伤时间比较均无明显差异(χ2或t=0.89、0.51、0.42、0.39,P0.05)。青年组的休克率明显高于老年组,死亡率明显低于老年组(χ2=4.55、5.73,P0.05)。老年组患者伤后发生感染、呼吸衰竭及肺栓塞等并发症的发生率明显高于青中年组(χ2=14.37、4.50、3.98,P0.05)。老年组的治愈出院率明显低于青中年组(χ2=23.96,P0.05)。结论老年严重多发伤患者伤后并发症发生率高,创伤性休克发生率高,死亡率高,应该采取积极的治疗措施,努力缩短急诊滞留时间,防治感染、呼吸衰竭及肺栓塞等严重并发症。
[Abstract]:Objective to investigate the clinical features and emergency treatment of severe multiple injuries in the elderly. Methods from January 2009 to January 2014, the clinical data and prognosis of 60 elderly patients receiving emergency surgery and 50 young and middle-aged patients with severe multiple injuries were compared and analyzed, and the clinical characteristics of the elderly patients with severe multiple injuries were summarized. The first aid measures were carried out. Results the proportion of craniocerebral injury in the elderly group was the highest, which was significantly higher than that in the young and middle age group, while the incidence rate of limbs or spine injury in the young and middle age group was the highest, and was significantly higher than that in the elderly group (蠂 ~ 2 3.95 ~ 4.02 P 0.05). The causes of injury in the elderly group were as follows: traffic injury in 26 cases, falling in 20 cases, falling injury in 12 cases and collapse in 2 cases. The causes of injury in the young and middle-aged group were as follows: traffic injury in 28 cases, falling in 5 cases, falling down in 5 cases, armed fight in 12 cases and 24. 00% in the middle age group, 1 case in the collapse, and 4 cases in the falling injury. There was no significant difference between the two groups in sex, number of injury sites, concise injury grading and injury severity score (AIS90-ISSs) and injury time (蠂 2 or t0. 89 卤0. 51U 0. 420.39) (P 0. 05 0. 05). The shock rate in the young group was significantly higher than that in the elderly group, and the mortality rate was significantly lower than that in the elderly group (蠂 ~ 2 4.55 ~ 5.73% P 0.05). The incidence of infection, respiratory failure and pulmonary embolism in the elderly group was significantly higher than that in the young and middle age group (蠂 2 14.37 4.50 3.98 P 0.05). The rate of cured discharge in the elderly group was significantly lower than that in the young and middle age group (蠂 2 = 23.96, P 0.05). Conclusion elderly patients with severe multiple injuries have high incidence of post-traumatic complications, high incidence of traumatic shock and high mortality. Active treatment measures should be taken to shorten the emergency stay time and prevent infection. Respiratory failure and pulmonary embolism and other serious complications.
【作者单位】：广东医学院附属医院急救中心;
【分类号】：R641

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