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严重多发伤的ICU监护及治疗

Monitor and treatment of patients with severe multiple trauma in Intensive Care Unit

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【作者】 黄显凯蒋耀光周健费军

【Author】 HUANG Xian-kai,JIANG Yao-guang,ZHOU Jian,et al. (Trauma Center,Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing 400042,China)

【机构】 第三军医大学大坪医院野战外科研究所全军战创伤中心第三军医大学大坪医院野战外科研究所全军战创伤中心 重庆400042重庆400042重庆400042

【摘要】 目的 探讨ICU监护及治疗在严重多发伤救治中的作用。方法 总结 1990年 1月~ 2 0 0 4年 3月接受ICU监护和治疗的 2 2 36例严重多发伤临床资料 ,分析严重多发伤ICU监护及治疗中的几个重要问题 ,并提出处理要点。结果 本组发生急性呼吸窘迫综合征 (ARDS) 2 4 2例 (10 .82 % ) ,多器官功能障碍综合征 (MODS) 2 5 3例 (11.31% ) ,应激性溃疡伴出血 114例 (5 .0 9% ) ;其治愈率分别为 6 9.0 1% (16 7/ 2 4 2 )、5 1.78%(131/ 2 5 3)、73.6 8% (84 / 114 )。全组总治愈率 89.0 4 % (1991/ 2 2 36 ) ,死亡率 10 .96 % (2 4 5 / 2 2 36 )。结论 加强ICU与创伤外科医生的协作 ;及时解决ICU治疗中发生的外科问题 ;维护重要脏器功能 ,减少内脏并发症发生 ;发挥ICU人员对基层医院的指导作用等措施对提高严重多发伤的救治成功率起重要作用。

【Abstract】 Objective To explore the role of monitor and treatment for patient with severe multiple trauma in Intensive Care Unit(ICU).Methods The clinical data of 2*!236 patients with severe multiple trauma monitored and treated in ICU from Jan 1990 to Mar 2004 was studied retrospectively.Several problems about monitor and treatment of patients with severe multiple trauma were analyzed,and the key points of management for these patients were discussed.Results The incidence of ARDS,MODS,and stress ulcer were 10.82%,11.31%,and 5.09% respetively.Cure rate of ARDS,MODS,and stress ulcer were 69.01%(167/242),51.78%(131/253)and 73.68%(84/114)respetively.Cure rate of all patients was 89.04%(1991/2236),mortality was 10.96%(245/2236).Conclusion It is important and essential to emphasis cooperation between surgeon and physicians in ICU for a successful treatment:surgical problems are solved promatly,function of important organs are preserved,damage of function of important organs are decreased.These principles should be emphasized to doctors in primary level hospital.

【关键词】 多发伤重症监护手术治疗
【Key words】 multiple traumaintensive caresurgerytreatment
  • 【文献出处】 创伤外科杂志 ,Journal of Traumatic Surgery , 编辑部邮箱 ,2004年05期
  • 【分类号】R641
  • 【被引频次】6
  • 【下载频次】141
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