de Boer H H, Horrevorts A M, Gimbrère J S
Injury. 1982 Jul;14(1):35-8. doi: 10.1016/s0020-1383(82)80009-0.
The records of 146 consecutive multiply injured patients treated between 1976 and 1981 have been studied. Thirty-five patients underwent emergency laparotomy and in 24 patients the laparotomy was done 4 or more hours after admission. Eight of the 35 patients of the third group died, in 4 of whom the cause was head injury. The other 4 patients were extremely severely injured (Injury Severity Scores from 66 to 75). In the second group, 6 patients died, 5 from multi-organ failure due to sepsis and 1 patient from hypovolaemic shock. The more aggressive approach--to prevent multi-organ failure--is advised. The laparotomy, if indicated, must be done as an emergency procedure. During the same procedure fractures can be stabilized. In the postoperative period, mechanical ventilation should be instituted. Fresh blood should be given when more than 4000 ml stored blood is transfused, to prevent any tendency to bleed.
对1976年至1981年间连续收治的146例多发伤患者的记录进行了研究。35例患者接受了急诊剖腹手术，其中24例患者在入院4小时或更长时间后进行了剖腹手术。第三组35例患者中有8例死亡，其中4例死因是头部损伤。另外4例患者伤势极其严重（损伤严重度评分66至75分）。第二组中有6例患者死亡，5例死于败血症导致的多器官功能衰竭，1例死于低血容量性休克。建议采取更积极的方法来预防多器官功能衰竭。如果有指征，剖腹手术必须作为急诊手术进行。在同一手术过程中，可以对骨折进行固定。术后应进行机械通气。当输注超过4000毫升库存血时，应输注新鲜血液，以防止出血倾向。
