论文部分内容阅读
目的分析胃肠功能障碍和严重多发伤患者病情之间的关系,并探讨不同治疗模式对患者预后的影响。方法分析62例严重多发伤患者的临床资料,其中有胃肠功能障碍者24例,无胃肠功能障碍者38例,这些患者收住或转入医院中心ICU治疗的23例、神经外科17例、骨科15例、普外科5例、胸外科2例。分析这些患者的急性生理和慢性健康状况评分(APACHEⅡ)、创伤严重度评分(ISS)、多器官功能障碍综合征(MODS)发生率,并分析比较组间差异。结果 62例患者有24例(38.7%)发生胃肠功能障碍,其APACHEⅡ评分、ISS评分和MODS发生率与无胃肠功能障碍组相比均明显升高(均P<0.01);ICU收治患者的胃肠功能障碍发生率明显低于其他科室(均P<0.05)。结论严重多发伤患者出现胃肠功能障碍提示患者病情严重,采用整体化观念的综合治疗措施可以改善胃肠功能,提高疗效。
Objective To analyze the relationship between gastrointestinal dysfunction and the severity of multiple trauma and explore the influence of different treatment modalities on the prognosis of patients. Methods The clinical data of 62 patients with severe multiple trauma were analyzed. Among them, 24 patients had gastrointestinal dysfunction, 38 patients had no gastrointestinal dysfunction. These patients were admitted to the hospital center ICU for treatment of 23 cases, neurosurgery 17 cases , 15 cases of orthopedics, 5 cases of general surgery and 2 cases of thoracic surgery. The acute physiology and chronic health status scores (APACHE II), trauma severity score (ISS) and multiple organ dysfunction syndrome (MODS) were analyzed in these patients, and the differences between the groups were analyzed. Results The gastrointestinal dysfunction occurred in 24 patients (38.7%) in 62 patients. The APACHEⅡscore, ISS score and incidence of MODS in 62 patients were significantly higher than those without gastrointestinal dysfunction (all P <0.01). ICU patients The incidence of gastrointestinal dysfunction was significantly lower than other departments (all P <0.05). Conclusion The occurrence of gastrointestinal dysfunction in patients with severe multiple trauma suggests that the patients are in serious condition. The comprehensive treatment measures with holistic concept can improve the gastrointestinal function and improve the curative effect.