论文部分内容阅读
目的:探讨汶川地震中早期评估线医院危重伤患者死亡风险的因素。方法:回顾性分析了四川大学华西医院地震伤员伤情数据库中2008年5月12日汶川地震后一线医院收治的危重伤患者,其中死亡31例,并纳入年龄与死亡患者相似的存活患者作为对照组744例,并记录是否开放伤,是否挤压掩埋,呼吸频率,收缩压,平均动脉压,脉搏,体温,格拉斯哥昏迷评分,胸廓挤压试验是否阳性以及是否存在腹部压痛共lO项可能影响预后且能在早期获得的指标。以logistic回归进行多因素分析,筛选汶川地震中早期评估线医院危重伤患者的死亡风险因素。结果:收缩压(<90 mmHg),格拉斯哥昏迷评分(<12分)以及出现腹部压痛是汶川地震中早期评估线医院危重伤患者的死亡风险因素。结论:地震中线医院若早期发现患者收缩压降低,格拉斯哥昏迷评分低于12分以及出现腹部压痛,此类患者死亡风险较高,建议密切监测积极治疗,或在病情稳定后尽早转二线救治医院。
Objective: To explore the early risk factors of death in critically injured patients in line hospitals in Wenchuan earthquake. Methods: Retrospectively analyzed 31 critically ill patients admitted to first-line hospital in Wenxian earthquake on May 12, 2008 in Huaxi Hospital earthquake wounded database of Sichuan University on May 12, 2008. 31 patients were included in this study. Survival patients with similar age and death were included as control A total of 744 patients were enrolled in the study and recorded whether they were open wounds, whether burial, respiratory rate, systolic blood pressure, mean arterial pressure, pulse rate, body temperature, Glasgow coma scale, thoracic compression test were positive, And can be obtained in the early indicators. Multivariate analysis was performed by logistic regression to screen the risk factors of death in critically injured patients in the early stage of the Wenchuan earthquake hospital. RESULTS: Systolic blood pressure (<90 mmHg), Glasgow Coma Scale (<12 points), and abdominal tenderness were risk factors for death in critically injured patients in hospitals in the early stages of the Wenchuan earthquake. CONCLUSIONS: Early detection of a reduction in systolic blood pressure in a seismogenic midline hospital, a Glasgow coma score of less than 12, and abdominal tenderness may result in a higher risk of death from such patients. It is recommended that active treatment be monitored closely or be transferred to a second hospital as soon as possible after the condition has stabilized.