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目的:总结16排螺旋CT大螺距(1∶1.75)扫描在严重多发伤患者检查中的临床应用经验,评估其在严重多发伤救治过程中的价值。方法:对2009年10月-2013年10月我院收治的178例多发伤并有CT检查患者资料进行回顾性分析,其中男性141例,女性37例,头颈伤34例,面部伤22例,胸部伤78例,腹部伤70例,骨盆及四肢伤65例,体表伤159例。合并休克64例。ISS 10-54分,平均16.3分。178例到院后2h内16排螺旋CT检查。结果:螺旋CT检查时间8-12分钟。15例初检时有漏诊。急诊手术96例,其中启动绿色通道46例,非手术治疗82例。治愈170(95.5%);死亡8例(4.5%)。结论:多排螺旋CT大螺距扫描是严重多发伤患者的首选检查方法,能够明显缩短院内术前时间,尽早明确诊断和手术指征,指导急诊和/或手术医师明确严重多发伤及处理顺序,为提高救治成功率、挽救患者生命提供可靠依据。
OBJECTIVE: To summarize the clinical experience of 16-slice helical CT (1: 1.75) scan in the examination of patients with severe multiple trauma and evaluate its value in the treatment of severe multiple trauma. Methods: A retrospective analysis was performed on 178 cases of multiple traumatic injuries with CT examination in our hospital from October 2009 to October 2013. There were 141 males and 37 females, 34 head and neck injuries, 22 facial injuries, 78 cases of chest injury, 70 cases of abdominal injury, pelvis and limbs in 65 cases, 159 cases of body surface injury. 64 cases of shock. ISS 10-54 points, an average of 16.3 points. 178 cases to the hospital within 2h after 16-slice spiral CT examination. Results: Spiral CT examination time 8-12 minutes. 15 cases missed the initial examination. Emergency surgery in 96 cases, of which 46 cases started green channel, non-surgical treatment of 82 cases. 170 (95.5%) were cured and 8 died (4.5%). Conclusion: The multislice spiral CT scan is the first choice for patients with severe multiple traumas. It can shorten the time of hospital preoperatively, confirm the diagnosis and operation indications as soon as possible, instruct the emergency department and / or surgeon to identify the severe multiple trauma and the treatment sequence, To improve the success rate of treatment, save patients with life to provide a reliable basis.