【摘要】 目的:探讨多发伤并股骨干骨折患者内固定手术治疗时机,最大限度地降低患者的死亡率,最大限度地挽救生命。方法:回顾性分析2002至2011多发性创伤合并单侧股骨干骨折4178例患者,将患者分成24h内手术(ST1),24-72h手术(ST2),3-30d手术(ST3)三个组,并且将每组按照创伤严重程度分为轻度损伤和重度损伤,分析各个组间的死亡率和相对风险度。结果:轻度损伤中24h内急诊手术死亡率和3d后延迟手术的死亡率行X2检验分析,有明显统计学差异(X2=25.23,P﹤0.001),而24h内手术死亡率和24-72h手术的死亡率差异不明显(X2=1.03,P﹥0.05)。重度损伤中24h内急诊手术死亡率和3d后延迟手术的死亡率行X2检验分析,有统计学意义(X2=5.08,P﹤0.05),而24h内手术死亡率和24-72h手术的死亡率无差异(X2=0.89,P﹥0.05)。轻度损伤死亡率1.12%,重度损伤死亡率4.3%,二者显著性差异(X2=37.6,P﹤0.0001)。结论:早期手术可以降低多发伤并股骨干骨折死亡率,尤其在轻度损伤中较为明显,但创伤指数越高,死亡率越高,需要个体化治疗才能取得最佳治疗效果。更多还原

【Abstract】 Objective: To investigate the opportunity for multiple trauma and femoral shaft fractures in patients with fixed surgery,to reduce a patient’s risk of dying,to save life and health.Method: Retrospective analysed 4178 patients with multiple trauma combined unilateral femoral shaft fractures from 2002 to 2011,Patients were divided into three groups as follows: 24 hours of surgery(ST1),24 to 72 hours of surgery(ST2),3-30 days surgery(ST3).Each group were classified into mild and severe injury groups in accordance with the trauma severity score so as to analyze the mortality and relative risk level among groups.Result: The analysis of emergency surgery mortality within 24 hours and 3 days delay surgery mortality line chi-square test were conducted by X2.The results showed significant difference(chi-square = 25.23,P ﹤ 0.001),while the results of surgery mortality within 24 hours and surgery mortality within 24 to 72 hours of showed no obvious difference(chi-square = 1.03,P ﹥ 0.05).The analysis of severe damage within 24 hours of emergency surgery mortality and 3 days delay surgery mortality line chi-square test were conducted by X2,a statistical significance(chi-square = 5.08,P ﹤ 0.05)was found.while the results of surgery mortality within 24 hours and surgery mortality within 24 to 72 hours showed no difference(chi-square = 0.89,P ﹥ 0.05).The rate in mild damage group was 1.12%,while the one of severe damage group was 4.3%,significant difference found.(chi-square = 37.6,P ﹤ 0.0001).Conclusion: Early surgery can reduce the multiple trauma and femoral shaft fractures and mortality,especially in mild injury group.But mortality rate is increased with the trauma index,so personalized treatment is necessary for the best clinical effect.更多还原