Cheng Chang-Zhi, Zhao Dong-Hai, Li Quan-Yue, Qu Hai-Yan, Chen Bo-Cheng, Lin Zhou-Dan
303rd Hospital of People's Liberation Army, Nanning 530021, China.
Zhonghua Yi Xue Za Zhi. 2008 Dec 23;88(47):3325-8.
To explore the causes of death and risk factors in patients of war wound and trauma of extremities.
This retrospective study involved 352 patients of war wound and trauma of extremities admitted to 303rd Hospital of People's Liberation Army during the period between 1968 to 2002. All the data were reviewed and the causes of death of 15 patients were analyzed by autopsy, and a computer's logistic regression model analysis was performed to approach the risk factors of death.
Fifteen of the three hundred and fifty-two patients were died (4.3 %). The causes of death included acute renal failure (ARF) (46.7%, 7/15), lung embolism (20.0%, 3/15), clostridial myonecrosis (20.0%, 3/15) and multiple organ system failure (MOSF) (13.3%, 2/15). In the univariate analysis, the risk of death increased by shock, time admitted to hospital, amputation, time of tourniquet, associated injury of head, thoracic region, abdomen or blood vessel (P < 0. 05). In the logistic regression model analysis, shock and amputation were the two factors most strongly associated with the death of patients of war wound and trauma. (P < 0. 05).
Acute renal failure (ARF) was the main cause of death of patients of war wound and trauma of extremities. Its should be helpful for minimize the mortality of patients of war wound and trauma to manage the shock in time and have a correct choice of amputation promptly.
探讨四肢战伤与创伤患者的死亡原因及危险因素。
本回顾性研究纳入了1968年至2002年期间解放军第303医院收治的352例四肢战伤与创伤患者。回顾所有数据，对15例死亡患者的死因进行尸检分析，并采用计算机逻辑回归模型分析探讨死亡危险因素。
352例患者中有15例死亡（4.3%）。死亡原因包括急性肾衰竭（ARF）（46.7%，7/15）、肺栓塞（20.0%，3/15）、梭菌性肌坏死（20.0%，3/15）和多器官系统衰竭（MOSF）（13.3%，2/15）。单因素分析中，休克、入院时间、截肢、止血带使用时间、头、胸、腹或血管合并伤会增加死亡风险（P<0.05）。逻辑回归模型分析中，休克和截肢是与四肢战伤与创伤患者死亡最密切相关的两个因素（P<0.05）。
急性肾衰竭（ARF）是四肢战伤与创伤患者的主要死亡原因。及时处理休克并及时正确选择截肢有助于降低四肢战伤与创伤患者的死亡率。
