Cannell H, Paterson A, Loukota R
Department of Oral and Maxillofacial Surgery, Royal London Hospital, UK.
Br J Oral Maxillofac Surg. 1996 Aug;34(4):303-8. doi: 10.1016/s0266-4356(96)90007-8.
Experience in team management of multiply injured patients with maxillofacial injuries is reported. During 1992, out of 169 patients transferred to the Royal London Hospital, UK by the Helicopter Emergency medical Service 38 (22.4%) had injuries to the maxillofacial region, 17 of whom were scored on the Abbreviated Injury Scale (AIS) as having sustained facial AIS > 2. The median Injury Severity Score (ISS) was 22, while the ISS was 17.7 for survivors and 34.5 for those who died (chi 2 = 7.3, 0.05 < P > 0.02). Facial AIS (median 4) and facial AIS contribution to ISS were found to be poor indicators of severity of injury. Revised Trauma Score (RTS) and percentage probability of survival (Ps%) were found to be useful discriminators of severity of overall injuries. RTS compared between survivors and those who died was 0.05 < P > 0.02 (chi 2), while Ps% was 0.01 < P > 0.001 (chi 2). It was concluded that the severity of maxillofacial injuries, and hence their contribution to total injury assessments, tended to be underscored. We propose that refined facial injury assessment methods be tested.
本文报告了对多发伤合并颌面损伤患者进行团队管理的经验。1992年，在由直升机紧急医疗服务转运至英国皇家伦敦医院的169例患者中，38例（22.4%）存在颌面区域损伤，其中17例根据简明损伤定级标准（AIS）评分显示面部损伤AIS>2。损伤严重度评分（ISS）中位数为22，幸存者的ISS为17.7，死亡者的ISS为34.5（χ2=7.3，0.05
0.02）。发现面部AIS（中位数为4）及面部AIS对ISS的贡献并非损伤严重程度的良好指标。修订创伤评分（RTS）和生存概率百分比（Ps%）是总体损伤严重程度的有效判别指标。幸存者与死亡者之间的RTS比较，χ2检验显示0.05
0.02，而Ps%的χ2检验显示0.01
0.001。研究得出结论，颌面损伤的严重程度及其对总损伤评估的贡献往往被低估。我们建议测试更精确的面部损伤评估方法。
