严重创伤后急性肝功能损害的危险因素及防治策1.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(死亡率 26. 5% ) ;其中肝功能损害组死亡 20例(死亡率 44. 4% )明显高于无肝损组死亡 7例(死亡率 12. 3% )。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 of102 cases of severe injury during April 2003 to October 2004 were analyzed retrospectively,10 risk factors were chosen. Results: In allof102 cases ,27 cases died during the hospital stay(the mortality %),20 cases died in45 cases with acute hepatic injury (the mortality %), 7 cases died in57 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 press