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目的分析不同年龄组严重创伤的临床特征和救治结果,以提高严重创伤的急诊救治水平。方法1997年10月至2004年10月7年间共救治严重创伤患者2069例,分为儿童组(＜13岁)106例,少年组(13～18岁)128例,青壮年组(18～40岁)1518例,中年组(40～60岁)215例,老年组(＞60岁) 102例。入选病例按损伤严重程度评分(ISS)标准进行评估,所有患者ISSl≥16。结果各组男性患者均多于女性,青年组、中年组和老年组男性严重创伤比例显著高于儿童组和少年组(P＜0．01)。交通伤是首要致伤原因,儿童组、少年组和中年组高于青壮年和老年组(P＜0．01)；第二位致伤原因坠落伤在儿童组,械斗与工伤在少年组、青壮年组和中年组,跌伤在老年组中显著增高(P＜0．01)。儿童组和老年组以颅脑损伤为主；而少年组、青壮年组和中年组在四肢和(或)脊柱的损伤中显著增高(P＜0．05)。老年组腹部损伤显著减少(P＜0．01)。总病死率为11．9%(246/2 069),老年组创伤＜24 h病死率(20．6%,21/102)较≥24 h病死率(7．8%,8/102)显著增高(P＜0．01)。各组的急诊滞留时间,在抢救脱险病例和死亡病例之间比较,差异具有统计学意义(P＜0．01)。结论各年龄组严重创伤患者在性别构成、致伤原因和致伤部位的发病率及其特点是不同的,老年患者在遭受严重创伤后死亡率明显增高；观念上要重视“黄金1小时”,“白金10分钟”,缩短急诊滞留时间；早期实施手术抢救；应用损伤控制性手术。
Objective To analyze the clinical characteristics and treatment outcome of severe trauma in different age groups in order to improve the emergency treatment of severe trauma. Methods A total of 2069 patients with severe trauma were treated from October 1997 to October 2004. There were 106 children (<13 years), 128 children (13-18 years) and young adults (18-40 Year old), 1518 middle-aged patients (40-60 years old) and 102 elderly patients (> 60 years old). Selected cases were assessed according to the severity of injury (ISS) criteria, with ISSl ≥ 16 in all patients. Results The male patients in each group were more than those in the female group. The proportion of male patients with severe trauma in the youth group, the middle age group and the elderly group was significantly higher than that in the children group and the adolescent group (P <0.01). Traffic injury was the leading cause of injury, and children, adolescents and middle-aged were higher than those of young and old (P <0.01). The second cause of injury was fall injury in children group, fighting and injury in juvenile group , Young adults group and middle age group, the fall injury in the elderly group was significantly higher (P <0.01). The traumatic brain injury was the predominant in the children group and the elderly group, but was significantly increased in the juvenile group, the young adult group and the middle aged group (P <0.05). Abdominal injuries in the elderly group were significantly reduced (P <0.01). The overall case fatality rate was 11.9% (246/2 069). The mortality rate (20.6%, 21/102) in the elderly group was significantly higher than that in the> 24 h group (7.8%, 8/102) Increased (P <0.01). The emergency residence time in each group was significantly different between rescue and death cases (P <0.01). Conclusion The morbidity and characteristics of sex composition, the cause of injury and the injured parts of patients with severe trauma in all age groups are different. The mortality rate of elderly patients after severe trauma is significantly increased. The concept should pay attention to “1 hour of gold” “Platinum 10 minutes” to shorten the emergency stay; early implementation of surgical rescue; the application of controlled injury surgery.