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目的 :对我院急救部 1992— 1999年收治的中度以上创伤患者进行流行病学调查 ,以期对城市创伤的急救提出依据。方法 :从 42批 1145例创伤患者中筛选出中度以上者 719例进行统计分析。结果 :伤员构成 :男5 45例 ,女 174例 ,男∶女为 3.13∶ 1;年龄平均 (32 .3± 16 .7)岁 (4～ 86岁 ) ;创伤评分 (TS)平均 (13.2± 3.7)分 ,格拉斯哥昏迷评分 (GCS)平均 (11.7± 4.3)分 ,Clem mer氏评分 (CRAMS)平均 (7.46± 2 .40 )分 ,创伤严重程度评分 (ISS)平均 (19.3± 11.9)分。复合伤 13例 (1.8% ) ,多发伤 2 49例 (34 .6 % ) ;休克 12 5例 (2 9.9% ) ;脱险率 84.2 % ,抢救成功率 76 .7%。 2 0～ 2 9岁和 30～ 39岁两个年龄段占病例总数 5 7.3%。烧烫伤及火器伤占创伤的 15 .9%和 16 .8% ;机械伤占创伤的 6 7.3% ,创伤发生部位前 4位为四肢、头、胸、腹 ;致死部位前 3位为头、胸、腹 ;死亡发生率前 4位为大血管、骨盆、头、胸。收入重度患者最多的科室为 SICU(5 0 .2 % )。急诊时死亡 6 2例 (多发伤 2 2例、脑外伤 19例、烧伤 11例、刀伤 9例、失血 1例 ) ,手术 2 6例 (成活 6例 )。结论 :交通伤、坠落伤、刀伤及意外事故是城市创伤的主要因素。观念上要重视“白金 10分钟”;开展超级生命支持 ,急诊独立的手术体系并
OBJECTIVE: To carry out an epidemiological investigation on the trauma patients with moderate to severe trauma admitted in our emergency department from 1992 to 1999 in order to provide the basis for emergency treatment of urban trauma. Methods: From 42 batches of 1145 traumatic patients, we screened 719 cases with moderate or higher degree for statistical analysis. Results: The wounded consisted of 545 males and 174 females, with a mean age of 3.13: 1 for males and females (32.3 ± 16.7 years) and an average of 13.2 ± 3.7), average GCS (11.7 ± 4.3), average Clemmer’s score (7.46 ± 2.40), and average severity of trauma (ISS) (19.3 ± 11.9). Among them, 13 cases (1.8%) were complicated with trauma, 49 cases (34.6%) with multiple trauma, 125 cases (29.9%) with shock and 84.2% with rescue. The rescue success rate was 76.7%. The age range of 20 ~ 29 and 30 ~ 39 accounted for 53.3% of the total number of cases. Burns and firearm injuries accounted for 15.9% and 16.8% of traumas; mechanical wounds accounted for 6 7.3% of traumas, and the top 4 trauma sites were limbs, head, chest and abdomen; Chest, abdomen; the first 4 deaths for large blood vessels, pelvis, head and chest. The most heavily paid patients were SICU (52.2%). There were 62 deaths (22 with multiple traumas, 19 with traumatic brain injury, 11 with burns, 9 with knife wounds and 1 with blood loss) in emergency department and 26 with surgery (6 survived). CONCLUSION: Traffic injuries, crashes, wounds and accidents are the major causes of urban trauma. The concept should pay attention to “Platinum 10 minutes”; carry out super-life support, emergency and independent surgical system