Karwan Krzysztof
Wojskowy Instytut Medyczny w Warszawie, Szpitalny Oddział Ratunkowy CSK MON.
Pol Merkur Lekarski. 2009 Oct;27(160):296-301.
Polytrauma care is a very important diagnostic and therapeutic problem. The clinical profile of patients with multiorgan injuries admitted to the emergency department (ED) is different, similarly to severity of injuries.
An evaluation of patients with polytrauma treated in ED and proposition of diagnostic and therapeutic algorithm in initial management in patients with multiply injuries.
The analysis of medical data was performed in 72 polytraumized patients. Their age, sex, time of admission to ED, influence of alcohol and drugs, vital parameters, etiological factors, severity of injuries and the therapy after initial management in ED were studied.
The majority of patients were admitted to ED in the morning. There were 25 females and 47 males. Their mean age was 41 years. Patients between 21-40 years of age represented half of all victims. There were 10 patients under influence of alcohol or drugs. Vital signs like Glasgow Coma Scale (GCS), systolic blood pressure (SBP), and respiratory rate (RR) evaluated at the initial examination and counted as a values of Revised Trauma Score (RTS) in most cases were 7.841. The traffic accidents were the most frequent ethiologic factors. Head injuries, chest injuries and fractures were the most frequently. After initial treatment in ED, 22 patients were discharged home and 23 were hospitalized, because they had been needed surgical treatment, and 8 because of threat of life. 6 patients died in ED.
Multiorgan injuries were diagnosed mainly in young men after traffic accidents in the morning. Head injuries, chest injuries and fractures were the most frequent. Author propose the diagnostic and therapeutic algorithm for initial management in ED in patients with multiply injuries.
多发伤的治疗是一个非常重要的诊断和治疗问题。与损伤严重程度相似,急诊科收治的多器官损伤患者的临床特征也有所不同。
评估急诊科治疗的多发伤患者,并提出多发伤患者初始治疗中的诊断和治疗算法。
对72例多发伤患者的医疗数据进行分析。研究了他们的年龄、性别、入院急诊科的时间、酒精和药物的影响、生命体征、病因、损伤严重程度以及急诊科初始治疗后的治疗情况。
大多数患者于上午入院急诊科。有25名女性和47名男性。他们的平均年龄为41岁。21至40岁的患者占所有受害者的一半。有10名患者受酒精或药物影响。在初次检查时评估的格拉斯哥昏迷量表(GCS)、收缩压(SBP)和呼吸频率(RR)等生命体征,在大多数情况下作为修订创伤评分(RTS)的值为7.841。交通事故是最常见的病因。头部损伤、胸部损伤和骨折最为常见。在急诊科进行初始治疗后,22名患者出院回家,23名患者因需要手术治疗而住院,8名患者因生命受到威胁而住院。6名患者在急诊科死亡。
多器官损伤主要在上午交通事故后的年轻男性中被诊断出来。头部损伤、胸部损伤和骨折最为常见。作者提出了多发伤患者在急诊科初始治疗的诊断和治疗算法。