创伤急救模式对救治水平的影响  

Trauma first aid model influencing trauma treatment level

作　　者：邓勇[1] 柴中民[1] 韩庆[1] 王以国[1] 白卫东[1] 陈文凯[1] 

机构地区：[1]深圳市第二人民医院急救中心创伤外科,518020

出　　处：《中华创伤杂志》2004年第11期682-684,共3页Chinese Journal of Trauma

摘　　要：目的有效提高严重创伤患者的生存率。方法对深圳市第二人民医院急救中心1995年9月～2003年8月8年间救治的严重创伤[损伤严重程度评分(ISS)≥16或简明损伤定级(AIS)≥3]患者死亡情况进行比较分析。结果本组共2305例,死亡896例,死亡率38.87%。我科成立前4年(1995年9月～1999年8月)住院死亡率(28.55%,213/746)和住院前死亡率(31.05%,336/1082)分别明显高于成立后4年(1999年9月～2003年8月)住院死亡率(11.96%,119/995)(P<0.01)和住院前死亡率(18.64%,228/1223)(P<0.05)。我科成立后4年住院患者中伤后送达病房或手术室时间≥1h死亡率(13.49%,39/289),明显高于30～60min死亡率(7.74%,26/336)(P<0.05)和<30min死亡率(5.06%,4/79)(P<0.01)。8年间各年我院住院前死亡率依次逐渐降低。结论创伤必须专业化,力创时效性与整体性两大专科特色是提高创伤救治水平的根本保证,建立充满活力的创伤急救新模式是必要条件,加强急救复合型人才和创伤专业化人才培养是关键,创立区域化、多功能的创伤治疗中心是未来我国创伤救治的趋势。Objective To effectively improve survival rate of severe trauma. Methods The fatal outcome of cases with severe trauma (injury severity score, ISS≥16 or abbreviated injury score, AIS≥3) from September 1995 to August 2003 was analyzed comparatively. Results There were 2 305 cases, of which 896 died, with a mortality rate of 38.87%. The in hospital mortality rate (28.55%,213/746) and prehospital mortality rate(31.05%,336/1 082) from September 1995 to August 1999 were significantly higher than that (11.96%,119/995) ( P <0.01) and (18.64%,228/1 223) ( P <0.05) from September 1999 to August 2003, respectively. The mortality rate (13.49%, 39/289) in patients arriving hospital or receiving operation over one hour after injury was significantly higher than that ( 7.74% , 26/336) in patients 30-60 minutes after injury ( P <0.05) and that (5.06%, 4/79) in patients within 30 minutes ( P <0.01). The mortality rate showed a trend of gradual decrease in past eight years. Conclusions The specialization of trauma surgery characterized by effectiveness and integration plays a pivotal role in improvement of in hospital survival rate for cases with severe trauma. Building a new rigorous model of trauma first aid is necessary and strengthening on training of the staff with compound knowledge and specialty in trauma is also important. The tendency for trauma first aid is to build the regional multifunctional trauma care center in our country.

关 键 词：救治 创伤急救 院前死亡 住院死亡率 住院 严重创伤 患者 水平 简明 时效性 

分 类 号：R641[医药卫生—外科学] R459.7[医药卫生—临床医学]