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1、多发伤早期救治中64层螺旋CT的应用作者简介:张连阳(1966-),男,广东省潮阳市人,博士,教授,发表论文70余篇,主要从事创伤救治、普通外科方面研究。电话(023)68757991本课题负责人(通信作者):张连阳E-mailhpzhangly@163.com重庆第三军医大学大坪医院野战外科研究所全军战创伤中心(400042)张连阳姚元章王韬刘朝普李英才张宇黄显凯何奇元张伟国王毅陈蓉【摘要】目的探讨64层螺旋CT在多发伤早期救治中的作用。方法回顾性分析2006年1月~2007年10月间救治的284例多发伤,男232例,女52例;年龄平均34.5岁。头颈伤54例次,面
2、部伤35例次,胸部伤125例次,腹部伤112例次,骨盆及四肢伤104例次,体表伤254例次。合并休克103例次。ISS10~54分,平均16.3分。37例因伤情过重直接送入手术室,247例到院后3小时内64层螺旋CT检查。结果螺旋CT检查时间8.4分钟。21例初检时有漏诊。急诊手术154例,其中启动绿色通道74例,非手术治疗130例。治愈272例(95.8%);死亡12例(4.2%)。结论多发伤早期救治中应用64层螺旋CT有助于缩短院内术前时间,提高早期确诊率和救治水平。【关键词】多发伤;64层螺旋CT;早期救治Applicationof64-slicehelical
3、CTinearlytreatmentofmultipletraumaZHANGLian-yang,YAOYuan-zhang,WANGTao,LIUZhao-pu,LIYing-cai,ZHANGYu,HUANGXian-kai,HEQi-yuan,ZHANGWei-guo,WANGYi,CHENRong(TraumaCenterofPLA,ResearchInstituteofSurgery,DapingHospital,ThirdMilitaryMedicalUniversity,Chongqing400042,China)Abstract:Objective:T
4、odiscusstheroleof64-slicehelicalCTintreatmentofmultipletrauma.Methods:Aretrospectivestudywascarriedouton284caseofmultipletraumaincluding232malesand52females(withaverageageof34.5years)admittedfromJanuary2006toOctober2007.Injurysitesandinjuryfrequencyweredistributedatheadandneckin54cases(
5、times),facein35,thoracicregionin125,abdomenin112,pelvisandextremitiesin104andbodysurfacein254.Ofall,103cases(times)werecombinedwithshock.ISSwas10-54points,mean16.3points.Ofall,37casesweresentforoperationdirectlybecauseofsevereinjury,theother247caseswereexaminedwith64-slicehelicalCTwithi
6、n3hoursafteradmission,Results:Meantimeofexaminedwith64-slicehelicalCTwas8.4minutes.Misseddiagnosishappenedin21cases.Emergencyoperationwasdonein154cases,ofwhich74casesreceivedoperationviafreechannel.Atotalof130casesweretreatednon-surgically.Ofall,272cases(95.8%)survivedbut12(4.2%)died.Co
7、nclusion:Applicationof64-rowhelicalCTinearlytreatmentofmultipletraumaishelpfulforshorteningpreoperativetimeandenhanceearlydefinitediagnosisandtreatmentlevel.Keywords:Multipletrauma;64-slicehelicalCT;Earlytreatment多发伤伤情危重、复杂,需多学科协作急诊处理,早期救治中常有漏诊、延误处理等,导致并发症发生率高、死亡率高。速度是多发伤救治的灵魂,