Objective To testify the efficacy of revised trauma score （RTS） in evaluating the severity of trunk injury，analyze its inadequacy and make modifications to improve its specificity and accuracy in evaluating trunk injury. Methods Medical records of 278 patients undergoing emergency surgery for the treatment of trunk injury in West China Hospital of Sichuan University between January 2006 and June 2012 were retrospectively analyzed. There were 231 males and 47 females in the age of 1-75 （33.7±14.1） years. RTS was calculated for each patient. Hemoglobin （Hb） concentrations in these patients acquired at the emergency room were included to reflect the severity of blood loss. The correlations between RTS and patient response to treatment as well as RTS and prognosis were analyzed. Patient response to treatment and prognosis were compared between the normal RTS group and the abnormal RTS group. Univariate analysis was performed followed by multivariate analysis for the variables which may impact prognosis. Modified RTS was established by regression analysis. Results RTS was significantly correlated with patient response to treatment as well as prognosis. RTS was significantly correlated with the time duration between the onset of injury and the beginning of operation （r =0.249，P＜0.001）， thoracic and abdominal blood loss volume （r = -0.255，P＜0.001），fluid resuscitation volume （r = -0.244，P＜0.001） as well as length of ICU stay （r = -0.202，P=0.001）. Mortalities in patients with different RTS were statistically different （P=0.004）. In the patient group with normal RTS the mortality was 5.1%，which indicates the inadequacy of RTS in evaluating trunk injury. Univariate analysis revealed that both emergency room Hb and RTS were correlated with patients’ prognosis. After putting these two factors into the regression analysis，a new formula to calculate modified RTS is established：Logit （P death）=6.450-0.769×RTS-0.029×Emergency room Hb. Conclusion Modified RTS is more specific in evaluating trunk injury and maintains the advantages of simplicity and rapidness.
目的 觀察和評價采用偏心型封堵器導管介入治療干下型室間隔缺損的近期療效和安全性。 方法 2011年8月－12月，6例經無主動脈瓣脫垂的干下型室間隔缺損（直徑≤7 mm）患者（年齡＞3歲）在雜交手術室接受介入治療。造影評估后，建立動靜脈軌道，在保留導絲的情況下置入合適型號的國產偏心型室間隔缺損封堵器，并于術后定期隨訪復查。 結果 6例患者缺損直徑4～7 mm（平均5.3 mm），其中5例成功地接受了導管介入封堵治療，置入封堵器直徑5～9 mm（平均6.4 mm）。僅1例因封堵器置入后出現主動脈瓣受壓影響關閉，即改由外科微創經胸封堵成功。所有患者在隨訪期內，無栓塞、殘余分流、瓣膜功能障礙、房室傳導阻滯、死亡等并發癥。 結論 無主動脈瓣脫垂的干下型室間隔缺損患者接受導管介入封堵治療是安全、可行的，且短期隨訪結果良好。