Haasper C, Kalmbach M, Dikos G D, Meller R, Müller C, Krettek C, Hildebrand F, Frink M
Trauma Department, Hannover Medical School (MHH), Hannover, Germany.
Technol Health Care. 2010;18(2):89-100. doi: 10.3233/THC-2010-0571.
Despite recent advances in treatment of severe injured patients, e.g. due to damage control orthopaedics, multi organ dysfunction syndrome (MODS) and sepsis are major complications in daily practice. During one year 94 patients were prospectively collected.
ISS 16, age 18-60 y, primary admission to our level-1 trauma center, survival > 48 hours after trauma. The development of MODS and sepsis were observed and different groups were formed (+/-). Demographic data revealed no significant differences between the subgroups. Comparing groups +MODS and -MODS significant differences on admission day were observed, when PCT showed first on day 2 after trauma differences. Regarding the development of sepsis PCT was advantageous to IL-6 showing significant higher plasma levels in group +sepsis from the first day after trauma. Serum levels of IL-6 and PCT could be useful in early identification of high risk patients to develop posttraumatic MODS. For sepsis PCT is the better prognostic factor.
尽管在严重创伤患者的治疗方面取得了最新进展，例如由于损伤控制骨科技术的应用，但多器官功能障碍综合征（MODS）和脓毒症仍是日常医疗实践中的主要并发症。在一年的时间里，前瞻性收集了94例患者。
损伤严重度评分（ISS）为16，年龄18至60岁，首次入住我们的一级创伤中心，创伤后存活超过48小时。观察MODS和脓毒症的发生情况并形成不同组（阳性/阴性）。人口统计学数据显示各亚组之间无显著差异。比较MODS阳性组和MODS阴性组，在入院当天观察到显著差异，而降钙素原（PCT）在创伤后第2天才首次出现差异。关于脓毒症的发生，PCT比白细胞介素-6（IL-6）更具优势，脓毒症阳性组从创伤后第一天起血浆水平就显著更高。IL-6和PCT的血清水平可能有助于早期识别发生创伤后MODS的高危患者。对于脓毒症，PCT是更好的预后因素。
