贵州医科大学学报

2017, v.42;No.206(11) 1357-1362

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严重创伤伴骨盆骨折患者预后的危险因素分析
Analysis of Risk Factors Affecting Prognosis of Pelvic Fracture Associated with Major Trauma

佟梦琦;白颖;王姗;周宁;
TONG Mengqi;BAI Ying;WANG Shan;ZHOU Ning;Department of Intensive Care Unit,Beijing Jishuitan Hospital;Department of Mathematics,Northeastern Illinois University;

摘要(Abstract):

目的:探讨影响严重创伤伴骨盆骨折患者临床预后的危险因素。方法:收集55例严重创伤伴骨盆骨折患者的临床资料,比较伤后30 d时死亡患者和存活患者损伤严重程度(ISS)评分及急性生理与慢性健康(APACHEⅡ)评分,采用多因素线性方法分析影响患者总住院时间及ICU住院时间的因素,Logistic回归方法分析治疗后6个月及12个月时影响患者功能恢复情况的因素、治疗后12个月时影响患者工作恢复情况的因素。结果:伤后30 d内死亡患者ISS、APACHEⅡ评分明显高于存活患者(P<0.01),多因素线性回归结果显示,术后感染是ICU住院时间及总住院时间延长的危险因素(β=0.309、0.031,P=0.397、0.004),Logistic回归结果显示,术后感染是患者术后6个月不能独立生活的危险因素(OR=11.954,P=0.002),受伤后休克和高APACHEⅡ是患者术后12个月不能恢复工作的危险因素(OR=5.065、0.745,P=0.047、0.043)。结论:ISS、APACHEⅡ评分及术后感染和受伤后休克是影响严重创伤伴骨盆骨折患者短期及长期预后的危险因素。
Objective: To investigate the risk factors affecting prognosis of patients with pelvic fracture associated with major trauma. Methods: Baseline informations of 55 enrolled patients with pelvic fracture associated with major trauma were collected. The injury severity score( ISS) and the acute physiology and chronic health evaluation( APACHE Ⅱ) of the survival group and the death group were compared in 30 days after injury. The factors of the length of hospital and ICU stay were analyzed by the linear regression method,and the factors affecting the functional recovery and returning to work after treatment were analyzed by logistic regression method. Results: The death group's ISS and APACHE Ⅱ were significantly higher than those of the survival group within 30 days after injury( P <0. 01). The linear regression showed that infection after operation was risk factors affecting the length of hospital and ICU stay( β = 0. 309,0. 031,P = 0. 397,0. 004); Logistic regression showed that infection was also factors affecting independent living ability 6 month after operation( OR = 11. 954,P =0. 002). And shock and high APACHE Ⅱ level were associated with the factors of not returning to work in 12 month after operation( OR = 5. 065,0. 745,P = 0. 047,0. 043). Conclusions: ISS,APACHE Ⅱ,infection and shock after operation are risk factors affecting short and long term prognosis of patients with pelvic fracture associated with major trauma.

关键词(KeyWords): 骨盆骨折;预后;危险因素;损伤严重程度评分;急性生理与慢性健康评分;严重创伤
pelvic fracture;prognosis;risk factors;injury severity score;acute physiology and chronic health evaluation;major trauma

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作者(Author): 佟梦琦;白颖;王姗;周宁;
TONG Mengqi;BAI Ying;WANG Shan;ZHOU Ning;Department of Intensive Care Unit,Beijing Jishuitan Hospital;Department of Mathematics,Northeastern Illinois University;

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DOI: 10.19367/j.cnki.1000-2707.2017.11.027

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