摘要目的 探讨ICU治疗严重多发伤的伤情标准及意义. 方法 通过分析“中华创伤数据库”收录的解放军第一一七医院交通伤急救中心2006-2012年收治的64例(ISS≥20分)非死亡严重多发伤患者资料,比较ICU救治组和非ICU救治组在创伤评分、并发症、功能预后及医疗成本等方面的差异. 结果 两组患者ISS与新损伤严重度评分(new ISS,NISS)差异无统计学意义,但GCS和修正创伤记分(revised trauma score,RTS)差异有统计学意义(P＜0.05);两组患者住院天数和医疗费用等差异无统计学意义,但发生并发症例数和出院时功能独立性评定(functional independence measure,FIM)差异有统计学意义(P＜0.05).非ICU救治组发生并发症的可能性是ICU救治组的2.96倍.ICU救治组FIM为10.11 ±2.10,显著高于非ICU救治组(8.67 ±2.99) (P ＜0.05).结论 ISS≥20分的严重多发伤患者进入ICU治疗有利于降低并发症发生率.

abstractsObjective To investigate the criteria and significance for management of severe multiple trauma in the intensive care unit (ICU).Methods Data of 64 patients with non-fatal severe multi-trauma (ISS≥20) treated in the First Aid Center for Traffic Injuries in 117th Hospital of PLA between 2006-2012 documented in China Trauma Database were analyzed.Differences in trauma scoring,complications,functional prognosis and medical cost were analyzed between ICU and non-ICU patients.Results There were statistical differences for GCS and revised trauma score (RTS) between ICU patients and non-ICU patients (P ＜ 0.05),but the differences were insignificant for ISS and new ISS (NISS).Likewise,the differences were significant for complication incidence and functional independence measure (FIM) on discharge (P ＜ 0.05),but not in the length of hospital stay and medical cost.Complication incidence of non-ICU patients was 2.96 times that of ICU patients.FIM of ICU patients scored 10.11 ± 2.10,far higher than that of non-ICU patients (P ＜ 0.05).Conclusion For severe multiple trauma patients with ISS≥20,the admission to the ICU is helpful for reduction of the complication rate.