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目的探讨创伤指数(TI)在涉及腹腔脏器的多发伤诊治中的临床意义和指导价值。方法回顾分析我院2000年1月至2010年6月经手术治疗的76例重度创伤和危重伤患者的临床资料,根据TI分为三组:Ⅰ组10~15分,Ⅱ组16~20分,Ⅲ组21~28分。观察其TI与脏器受累数、严重并发症及病死率之间的关系。结果Ⅰ组27例,多发伤6例(22.22%),病死率为0,严重并发症发生率为0。Ⅱ组32例,多发伤18例(56.25%),病死率9.38%,严重并发症发生率为6.25%。其中多发伤病死率为11.11%,多发伤严重并发症发生率为11.11%。Ⅲ组17例,多发伤14例(82.35%),病死率为35.29%,严重并发症发生率为58.82%,其中多发伤病死率为35.71%。多发伤严重并发症发生率为71.42%。结论多发伤不是几个单一伤的简单相加,而是一种涉及多方面病理变化的严重损伤,当其TI≥16分时,并发症发生率及病死率较高,中、重度的创伤尤其是多发伤在诊治中常遗漏隐蔽脏器损伤的诊治,而TI的临床应用可以判断多发伤伤情的严重程度,减少漏诊率,早期防治严重并发症,提高救治水平,降低病死率。
Objective To investigate the clinical significance and guiding value of traumatic index (TI) in the diagnosis and treatment of multiple injuries involving abdominal viscera. Methods A retrospective analysis of our hospital from January 2000 to June 2010 76 cases of severe trauma and critically ill patients with clinical data, divided into three groups according to TI: Ⅰ group of 10 to 15 minutes, Ⅱ group of 16 to 20 minutes, Group Ⅲ 21 to 28 minutes. To observe the TI and organ involvement, serious complications and mortality between the relationship. Results In group Ⅰ, there were 27 cases with multiple trauma in 6 cases (22.22%), the case fatality rate was 0 and the rate of serious complication was 0. There were 32 cases in group Ⅱ, 18 cases were multiple injuries (56.25%), the case fatality rate was 9.38%. The incidence of serious complication was 6.25%. Incidence of multiple trauma was 11.11%, the incidence of multiple trauma serious complications was 11.11%. In group Ⅲ, there were 17 cases with multiple trauma in 14 cases (82.35%), the case fatality rate was 35.29%, the serious complication rate was 58.82%, and the multiple fatal case fatality rate was 35.71%. The incidence of multiple traumatic serious complications was 71.42%. Conclusions Multiple trauma is not a simple addition of a few single trauma, but a serious injury involving many pathological changes. When its TI≥16 points, the complication rate and mortality rate are higher. The moderate and severe trauma, especially Is often multiple injuries in the diagnosis and treatment often missed the hidden organ injury diagnosis and treatment, and the clinical application of TI can determine the severity of multiple injuries, reduce the rate of misdiagnosis, early prevention and treatment of serious complications, improve the level of treatment and reduce mortality.