Kafie F, Tominaga G T, Yoong B, Waxman K
Department of Surgery, University of California, Irvine Medical Center, Orange, USA.
Am Surg. 1997 Oct;63(10):889-92.
Associated factors related to outcome following blunt intestinal trauma requiring operative therapy were retrospectively reviewed in all trauma patients admitted to one Level I trauma center. Over 4.5 years, 7598 trauma patients were evaluated, with 62 patients having sustained 92 blunt intestinal injuries requiring operative intervention. Mean age was 34.5 years; mean Injury Severity Score was 22. Mechanism of injury was motor vehicle accident in 50 (81%), with 80 per cent being drivers. Associated intra-abdominal injuries occurred in 46 (74%) patients. Extra-abdominal injuries occurred in 56 patients (90%). Thirty-one patients suffered 82 complications or 2.6 complications per patient (comp/pt). Mortality from operative blunt trauma was associated with admission blood pressure < or = 90 mm Hg (57 vs 13%; P < 0.05), age > or = 24 years (26 vs 0%; P < 0.05), and Injury Severity Score > or = 35 (70 vs 8%; P < 0.05). Morbidity was associated with age > or = 24 years (1.5 vs 0.7 comp/pt; P < 0.05) and delay in operative therapy > or = 24 hours (3.3 vs 1.1 comp/pt; P < 0.05). Overall mortality was 18 per cent.
对一所一级创伤中心收治的所有创伤患者进行回顾性分析,以探讨钝性肠损伤需手术治疗后的相关预后因素。在4.5年的时间里,共评估了7598例创伤患者,其中62例患者发生了92处钝性肠损伤,需要进行手术干预。平均年龄为34.5岁;平均损伤严重度评分为22分。损伤机制为机动车事故的有50例(81%),其中80%为驾驶员。46例(74%)患者伴有腹内损伤。56例(90%)患者伴有腹外损伤。31例患者发生了82处并发症,平均每位患者2.6处并发症(并发症/患者)。手术钝性创伤导致的死亡与入院时血压≤90 mmHg(57%对13%;P<0.05)、年龄≥24岁(26%对0%;P<0.05)以及损伤严重度评分≥35分(70%对8%;P<0.05)有关。并发症的发生与年龄≥24岁(1.5处并发症/患者对0.7处并发症/患者;P<0.05)以及手术治疗延迟≥24小时(3.3处并发症/患者对1.1处并发症/患者;P<0.05)有关。总体死亡率为18%。