严重创伤后急性肝功能损害的危险因素及防治策略论文.doc

严重创伤后急性肝功能损害的危险因素及防治策略
钱何布1 郑志群 1 林兆奋 2 许永华2
1 江苏省吴江市第一人民医院ICU,江苏吴江 215200,2上海第二军医大学长征医院急救科
摘要目的:探讨严重创伤后急性肝功能损害的危险因素及防治策略。方法:回顾分析2003年4月~2004年10月间收治的102例严重创伤患者的临床资料,对可能与急性肝功能损害相关的10项因素进行统计分析,以确定其高危因素,并探讨其防治方法。结果:本组102例中并发急性肝功能损害45例,住院期间死亡27例(%);其中肝功能损害组死亡20例(%)明显高于无肝损组死亡7例(%)。创伤评分(TS),低血压,低血氧,严重感染及大量输血和急性肝功能损害密切相关。结论:创伤评分(TS)≤12分,低血压,低血氧,严重感染及大量输血是急性肝功能损害的高危因素;早期发现并采取综合防治措施,有利于改善预后。
关键词创伤急性肝功能损害急性肝衰竭治疗
The risk factors and treatment strategy of acute hepatic injury after severe trauma QIAN He-bu,ZHENG Zhi-qun,LIN Zhao-feng,XU Yong-hua . Department of ICU, Wujiang First Hospital ,Wujiang Jiangsu 215200
[Abstract]Objiective: To investigate the high risk factors and treatment strategy of acute hepatic injury after severe trauma. Methods: The clinical data of 102 cases of severe injury during April 2003 to October 2004 were analyzed retrospectively,10 risk factors were chosen. Results: In all of 102 cases ,27 cases died during the hospital stay(the mortality %),20 cases died in 45 cases with acute hepatic injury (the mortality %), 7 cases died in 57 cases without hepatic injury(the mortality %). The study showed a significant relation to trauma score, lower blood pressure, lower blood oxygen, severe infection and large quantity blood transfusion(≥2000ml/24hours) .Conclusion: Lower trauma score, lower blood pressure, lower blood oxygen, severe