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題名 | Traumatic Asphyxia: A Clinical Evaluation=創傷性窒息:一項臨床評估 |
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作者 | 徐榆堡; 陳瑞杰; 卜樂得; 方禎鋒; 林炳川; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 30:6 民86.11-12 |
頁次 | 頁409-414 |
分類號 | 416.284 |
關鍵詞 | 創傷性窒息; Traumatic asphyxia; Glasgow coma scale; GCS; Revised trauma score; RTS; Injury severity score; ISS; |
語文 | 英文(English) |
中文摘要 | 於1991年12月至1997年1月,作者總共收集28位病人,其臨床表現皆符合創傷性窒息的臨床表徵:胸腹部鈍挫傷,不同程度之頭頸部發紺或出血點,及結膜下出血;其中16人為男性,12人為女性;受傷嚴重指數(ISS )為3至58分,其中大多低於10分(50.0%);ISS低於20分共有18位病人,無人死亡;ISS高於20分則有10位,其中2位死亡,死亡率為20.0%;初至急診時,7位病人 的昏迷指數(GCS)低於9分,但其中6位則於住院治療24小時內,意識完全恢復。 受傷的機制包括被車輛輾過或撞到(15),工作中不慎被捲軸機器捲入(7),或被重物壓傷(5),及從高處跌落(1)。相關的器官傷害,大部份為胸部,骨骼,或腦部的傷害;兩例為死亡病例,一例為肺部挫傷合併成人呼吸窘迫症;另一例為顱內出血併發上消化道出血。由以上的統計,我們認為,創傷性窒息其預後一般良好,縱使初期昏迷指數不佳;ISS低於20分的病人,其臨床預後可能較佳,但需更多資料來支持及評估;而其死亡原因通常與其它器官受傷的嚴重程度相關。 |
英文摘要 | From December 1991 throughJanuary 1997, 28 cases with clinical evidence of traumatic asphyxia were treated at our hospitaI. They all presented with thoracoabdominal blunt trauma and varying degrees of cervicofacial cyanosis, petechiae and subconjunctival hemorrhage. There were 16 male and 12 female patients.The injury severity score (ISS) ranged from 3 to 58 with most patients having scores of less than 10 (50%). There were no deaths among those with ISS<20, but a high mortality rate (20%) was found in patients with ISS >20. Seven patients had low Glasgow Coma Scale scores (GCS<9), in whom six patients recovered consciousness within 24 hours. The mechanisms of injury included being run over or struck by motorvehicles (15), crushed by roller machines at work (7), compressed by a heavy weight (5), and falling from a height (1). Associated injuries included rib fractures (8), lung contusions (5), hemo-pneumothoraxes (4), long bone fractures (4), pelvic fractures (2), intracranial hemorrhages (2), brachial plexus neuropathy (2), and liver or spleen lacerations (2). Two patients eventually died. One had a severe lung contusion and subsequent respiratory failure; the other suffered from an intracerebral hemorrhage and an ensuing upper gastrointestinal bleeding. In this series, the prognosis following traumatic asphyxia was good, even in patients with initialIy low GCS scores. The mortality rate was related to the associated organ injuries. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。