摘要
目的 分析无急诊手术指征的老年创伤患者受伤至手术的间隔时间与预后的关系。方法 选择2017年1月—2018年6月134例收治的因创伤入院但无急诊手术指征的老年(≥65岁)患者的临床资料,按照受伤至手术的间隔时间分为早期手术组(伤后7d内手术)71例和晚期手术组(伤后7d以后手术)63例。对比2组的一般资料、住院时间、ICU住院时间、并发症发生率和好转出院情况。结果 2组性别、年龄、致伤机制、基础疾病、创伤严重程度评分(ISS)、急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)评分比较差异无统计学意义(P>0.05),但早期手术组总住院时间短于晚期手术组,并发症发生率低于晚期手术组(P<0.05,P<0.01)。早期手术组肺部感染和静脉血栓形成发生率低于晚期手术组(P<0.05,P<0.01)。结论 非急诊老年创伤重症患者伤后早期手术有助于减少肺部感染、静脉血栓形成,缩短总住院时间。
Objective To analyze relationship between interval time from trauma to surgery with prognosis in elderly patients with severe trauma without indications for emergency surgery. Methods Clinical data of 134 elderly patients equal or more than 65 years old without indications for emergency surgery admitted during January 2017 and June 2018 was retrospectively analyzed, and the patients were divided into early surgery group ( n =71, having surgery within 7 d after injury) and late surgery group ( n =63, having surgery later 7 d after injury) according to interval time from trauma to surgery. General informations, hospital stays, ICU stays, incidence rate of complications and discharge conditions after getting better were compared between two groups. Results There were no significant differences in gender, age, vulnerate mechanism, underlying disease, injury severity scale (ISS) score and acute physiology and chronic health evaluation Ⅱ( APACHEⅡ) score between two groups ( P >0.05). However, in early surgery group, the total hospital stays was significantly shorter, and incidence rate of complications was significantly lower than those in late surgery group ( P < 0.05, P <0.01). Incidence rates of pulmonary infection and venous thrombosis in early surgery group were significantly lower than those in late surgery group ( P <0.05, P <0.01). Conclusion Early post-injury surgery for elderly patients with severe trauma without indications for emergency surgery may help reduce incidence rates of pulmonary infection and venous thrombosis, and shorten hospital stay.
作者
敬慧丹
李洪超
艾山木
蒋东坡
JING Hui-dan;LI Hong-chao;AI Shan-mu;JIANG Dong-po(Intensive Care Unit, Special Medical Center of PLA Army,Chongqing 400042, China)
出处
《解放军医药杂志》
CAS
2019年第7期64-67,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
军队面上项目(CS317L015)
关键词
创伤和损伤
早期手术
手术后并发症
预后
老年人
Wounds and injuries
Early surgery
Postoperative complications
Prognosis
Aged
