老年创伤重症患者病情特征及救治模式探讨
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国家自然科学基金青年基金(81400040)


Investigation of the disease characteristics and treatment mode of oldtraumatized patients
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    【摘要】目的 探讨老年创伤重症患者的病情特征及救治模式。方法 纳入2013年创伤ICU收治的60岁以上患者, 统计患者基础情况、伤情及入院病情特征;分析治疗期间诊治的主要内容, 结合主要诊治内容进行统计描述, 总结老年创伤重症患者的病情特征及救治模式。结果 共纳入老年创伤重症患者31 例, 无致命伤, 整体创伤不严重, 但合并症多, 易并发肺部感染、血栓形成、胃肠功能紊乱导致危重度明显增加(APACHII 12~24分) 。救治主要模式包括:防控肺部感染、防控血栓、胃肠道功能调控、坠床预防及全身康复五个方面;治疗期间主动无创呼吸支持2例次, 有创呼吸机支持5例, 所有病例均康复出院。结论 高龄患者在创伤后, 因其年龄大, 基础疾病多, 脏器功能代偿能力差等特点, 具有特别的病情特征, 表现为肺部感染高发且临床表现不典型;易形成血栓, 且抗凝后出血发生率高;胃肠道功能障碍高发等。本文的集束化诊治模式取得良好效果, 可在临床推广应用。

    Abstract:

    【Abstract】Objective To investigate the treatment mode of elderly critical patients.MethodsThe basic information, traumatic condition, and features of elderly critical patients over 60 during 2013 were reviewed. The therapeutic process of patients during hospitalization and statistical description and the disease characteristics and treatment mode of oldtraumatized patients were summarized. Results 31 patients were enrolled.The trauma was not fatal and not serious overall. The severity of critical disease was still significantly increased (APACHII:12~24)because of many complications, susceptible to pulmonary infection, thrombosis, gastrointestinal disorders. The main treatments include prevention of the pulmonary infection, thrombus and falling out of bed, regulating gastrointestinal function and rehabilitation. During hospitalization, 2 times active noninvasive ventilator and 5 times invasive ventilator were carried out. All the patients recovered and discharged.Conclusion Because of older ages, multiconsolidated basis, the organs compensate space are narrow, the elder patients have special conditions posttrauma, inclueding high risk of lung infections with atypical symptoms, thrombosis and hemorrhage after anticoagulant therapy and gastrointestinal disorders.

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  • 在线发布日期: 2017-12-18
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