|
Objective To investigate the early recovery phase of the whole body CT (whole-body computed tomography, WBCT) check the impact on clinical outcomes in patients with severe multiple injuries, and to assess their role in the early diagnosis and treatment of severe multiple trauma patients. Method 1. Retrospective analysis of our hospital from March 2007 to February 2010, the consolidated severe blunt multiple trauma patients admitted to ICU. Inclusion criteria: (1) age gt; 16 years old; ② The match multiple trauma diagnostic criteria; the ③ ISS gt; 16 points; ④ general ICU directly from the emergency department or operating room income patients; ⑤ initial stay in wards, but 72 hours from the condition deteriorate into general ICU patients. Exclusion criteria: ① outside the hospital emergency department or hospitalized patients transferred to our hospital; ② The recent patients suffering from serious diseases. Design the recovery phase of the diagnosis and treatment of trauma patients during the ICU questionnaire and severe multiple trauma patients with severe multiple diagnosis and treatment information questionnaire. Collect all compliant patient's diagnosis and treatment information. Whole-body CT examination whether the recovery phase, and not the whole body CT (non-whole-body computed tomography, N-WBCT) group divided into body CT group (WBCT group). Clinical observations, including age, gender, mechanism of injury, ISS, GCS, APACHE II score, the CT anatomic site, the CT inspection time, emergency room residence time, accidents, missed diagnosis, duration of mechanical ventilation, live in the general ICU days and mortality. 4. Statistical analysis: between the two groups mean compared using the t test or the Mann-Whitney U test, count data using χ2 test. P lt; 0.05 was considered statistically significant. Results 1. Were collected and input data of 187 patients, including N-WBCT 122 cases, WBCT group of 65 patients. 2 patients age, sex, mechanism of injury, APACHE II score, CT time and emergency room residence time were not significantly different. However, the WBCT group patients with ISS significantly higher than the N-WBCT patients (P = 0.010); the WBCT group patients with GCS significantly lower than the the N-WBCT group patients (P = 0.028). Two groups of patients with mechanical ventilation (9.58 ± 13.35 days vs 5.97 ± 8.06 days, P = 0.047) and live in general ICU days (12.62 ± 13.46 days vs 8.97 ± 8.66 days, P = 0.049), the difference was significant ; but no significant difference in mortality rate. 4.N-WBCT group of 28 patients missed, and found a total of 44 cases of misdiagnosis, of which 13 cases have clinically significant; WBCT group, 7 patients missed, and found a total of 11 cases of misdiagnosis, of which 4 cases has significant clinical significance. The two groups of patients the rate of misdiagnosis comparison, the difference was statistically significant (P = 0.049). Were no clinically significant accident transshipment and inspection process. Conclusion The early recovery phase body CT examination no increase in severe multiple trauma patients transporter accident risk, and contribute to the to reduce misdiagnosis incidence shorten the duration of mechanical ventilation, and live in the general ICU days.
|