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頁籤選單縮合
題名 | Response of Resuscitation in Multiple Trauma with Pelvic Fracture=多重創傷合併骨盆損傷的急救反應 |
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作者 | 陳維恭; 施信嶔; 蘇正熙; 李建賢; Chen, Wei-kung; Shih, Hsin-chin; Su, Cheng-hsi; Lee, Chen-hsen; |
期刊 | 中華醫學雜誌 |
出版日期 | 19970800 |
卷期 | 60:2 1997.08[民86.08] |
頁次 | 頁98-104 |
分類號 | 416.26 |
語文 | eng |
關鍵詞 | 血液動力學; 骨盆損傷; 復甦術; Hemodynamics; Pelvic fracture; Resuscitation; |
中文摘要 | 背景:合併有骨盆損傷的病人,早期的處理對急診或創傷醫師而言仍然是一種挑戰。本回溯性研究,將探討本院骨盆損傷病人在施行復甦術過程中不同反應的臨床意義。 方法:從1989年3月至1995年5月,有75位初期血液動力學不穩定的骨盆損傷病人進入本研究。依據立即施行復甦術後的反應,分為良好反應、延遲反應、不良反應及無反應四組。 結果:機動車輛意外事故的發生率比其它機轉高。骨折的類型和急救的反應無相關。損傷嚴重程度指數(ISS)中,不良反應組(41.7 ± 18.3)比良好反應組(17.5 ± 85)及延遲反應組(19.5 ± 17.0)高。非源自骨盆的出血及死亡率在不良反應組(38%及75%)比延遲反應組(25%及13%)或良好反應組(6%及2%)高。 結論:立即施行復甦術後的反應,對評估血液動力學不穩定的骨盆損傷病人相當有價值。在不良反應組及延遲反應組的病人,除了積極施行復甦術外,必須同時排除非源自骨盆的出血,特別是源自腹腔的出血。不良反應組的預後可以同時預測是不好的。 |
英文摘要 | Background: The early management of patients with pelvic injury remains a great challenge for emergency physicians and trauma surgeons. A retrospective study was performed in this hospital to identify the clinical significance of different responses in the resuscitation of pelvic injury. Methods: From March 1989 to May 1995, 75 patients with pelvic ring injury who had initially had unstable hemodynamic status were studied. They were divided into four groups as "good response" (GR), "delayed response" (DR), "poor response" (PR) and "no response" (NR) according to the time when hemodynamics became stable after immediate resuscitation. Results: Motor vehicle accidents (MVA) had a higher incidence than other causes in the trauma mechanism. The fracture types of pelvis had no correlation with the response to resuscitation. The injury severity score (ISS) was higher in the PR group (41.7 +/- 18.3) than in the GR (17.5 +/- 8.6) or DR (19.5 +/- 17.0). The incidence of extrapelvic hemorrhage (EPH) and of mortality rates was higher in the PR group (38% and 75%, respectively), and the DR group (25% and 13%, respectively), than in the GR group (6% and 2%, respectively). Conclusions: The responses of resuscitation is a valuable parameter in the management of multiple trauma with pelvic injury. Nonoperative treatment may be tried in patients of good response to resuscitation with EPH. In those patients with poor or delayed response, delayed extrapelvic bleeding (especially from abdominal injury) must be ruled out besides aggressive management for pelvic injury. Poor prognosis can also be expected in those patients with poor response. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。