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Clinical analysis of emergency treatment of 326 patients with oral craniomaxillofacial trauma under triage system
GE Wei-wen, WU Jia-jun, GE Kui, FAN Jing-xian, XU Hui, XU Bing, ZHANG Yong, ZHANG Shi-lei, ZHANG Lei
2023, 21 (1):
64-68.
doi: 10.19438/j.cjoms.2023.01.011
PURPOSE: To summarize the experience of emergency treatment of oral craniomaxillofacial trauma under triage system. METHODS: The emergency treatment of patients with craniomaxillofacial trauma in the Southern District of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from September 2020 to August 2021 was retrospectively analyzed. A total of 36 599 patients were treated during the period, 1 683 cases were treated by emergency observation and 326 were hospitalized. Pre-admission treatment of inpatients, including basic life support (emergency hemostasis, fluid resuscitation, injury control surgery), injury situations, advanced life support, multidisciplinary treatment and outcomes, were collected. SPSS 13.0 software package was used for statistical analysis. RESULTS: Among 326 emergency patients, 253 were male and 73 were female, with a ratio of 3.47 to 1. Their age ranged from 20 to 73 years, with an average of 41.64±15.34 years. The most common cause was road traffic injury (169 cases), including 138 cases due to electric vehicle accident (81.63%). Life accident injury was followed by 89 cases, including 65 cases of fall injury, accounting for 73.01%. Thirty-three cases had work-related injury, including 14 of fall injury, accounting for 42.42%. Other caused of injuries were noted in 35 cases. Eighty-three patients received primary life support (ECG monitoring, fluid resuscitation, debridement and hemostasis), including 30 patients with blood transfusion, 7 patients with endotracheal intubation or incision, and 9 patients with plaster or braces fixation. Damage control surgery was performed in 65 patients. A total of 235 patients were admitted directly to the Department of Oral and Craniomaxillofacial Surgery, 54 patients were admitted to the corresponding specialty based on trauma, and 37 patients were admitted to EICU to continue advanced life support. All patients were successfully treated, 326 patients were treated by emergency or delayed surgery, and 4 patients were discharged from hospital for secondary repair. CONCLUSIONS: Specialized diagnosis and treatment with first aid is an effective measure to solve the increasing demand for treatment of oral and maxillofacial trauma under triage system. The key to successful treatment of multiple maxillofacial injuries is to take life saving, organ function protection and reconstruction, and social regression as the center to carry out cooperation among various specialties, led by the emergency department.
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