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신체 타부위 손상을 동반한 악안면골 골절 환자의 손상중증도 평점(Injury Severity Score)에 관한 임상적 연구

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 (The) clinical study about injury severity score in patients with facial bone fractures associated with injuries on other sites 
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본 연구는 신체타부위 손상을 동반한 악안면골 골절환자의 손상중증도 평점에 관한 임상적 연구로서, 연구대상은 1981년 1월부터 1986년 12월까지 세브란스병원 및 원주기독병원에서 신체타부위 손상을 동반한 악안면골 골절환자 416명을 대상으로 하였다.

연구결과, 다음과 같은 결론을 얻었다.

1. 악안면골 골절을 동반한 타부위 관련 손상부위는 두경부 57%, 사지부 27%, 흉부 9%, 복부 7%의 순이었다.

2. 다발성 손상환자에서 전위된 악안면골 골절은 하악골골절 39%, 관골골절 25%, 상악골 골절중 Le Ford Ⅱ 24%, Le Fort Ⅲ 12% 순이었다.

3. 응급실에 내원하여 최초로 입원한 전문과는 신경외과 (73%), 정형외과(10%), 구강외과(6%) 순이었다.

4. 생존환자의 평균 손상중증도평점은 24이고 사망환자는 38이었으나, 생존환자중 이보다 높은 경우(6%)도 있었다.

5. 사망의 주요 원인으로는 두부 손상이 60%로 가장 많았고, 저혈량성 쇼크(12.5%), 폐혈증(12.5%), 기흉(6%)순이었다.

6. 내원 당일 악안면골 골절로 응급 수술을 시행한 경우는 60증례(14%)였는데, 이중 21증례(5%)에서 구강외과 단독으로 시행하였다.

7. 다발성 손상환자에서 남자가 81%로 많았고, 연령별로는 20대가 37%, 40대가 20%, 30대가 13%순이었다.


This is a retrospective study about ISS(Injury Severity Score) of facial bone fractures with multiple injuries on other sites. The study was based on a series of 416 patients with facial bone fractures treated as patients at Severance Hospital and Won Joo Christian Hospital during the period of Jan., 1981 through Dec., 1986.

The results were obtained as follows:

1. The most common location was head and neck(57%) among multiple injuries with facial bone fracture. The extremities(27%), chest(9%), abdomen(7%) were then next

in order of frequency.

2. Mandible fracture was predominent as 39% and there were also zygoma fracture(25%), Le Fort Ⅱ fracture(24%), Le Fort Ⅲ fracture(12%).

3. In Dept. of first admission, Neurosurgery was predominant as 73% and Orthopedic Surgery(10%), Oral Surgery(6%), others in order.

4. The mean Injury Severity Score was 24 in survival patients and 38 in died patients, but there were variable changes on minimum and maximum score.

5. The most common causes of death were intracranial injury(60%) hypovolemic shock(12.5%), sepsis(12.5), pneumothorax(6%) respectively.

6. Emergency operation was carried in 60 patients(14%) for facial bone fractures.

7. The ratio of male to female was 4.1:1, and 3rd decade(37%) was the highest age group in incidence.
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