严重道路交通伤院前院内一体化救护的研究  

Integrated Pre- and In-hospital Medical Rescue of Severe Road Traffic Injuries

作　　者：刘小红[1] 白晓 梁小燕[1] 谢培增[3] 刘剑[3] 汪先兵[3] 

机构地区：[1]解放军421医院急诊科,广东广州510318 [2]武警陕西省总队医院检验科 [3]解放军421医院神经外科,广东广州510318

出　　处：《华南国防医学杂志》2011年第1期57-59,共3页Military Medical Journal of South China

基　　金：全军医学科学技术"十一五"课题(06MB174)

摘　　要：目的探讨严重道路交通伤院前院内一体化救护模式及效果。方法 2006-01/2010-10月,院前救护站4人和应急医疗队的4、8、12和48人的编组构成与展开流程的实践回顾。全组展开救护510起,救治严重交通伤病人1976例,对有关伤员现场分类,心、肺、脑复苏,急救手术;后送途中的有效处理;院内急救、手术与术后处理,且观察临床治疗结果。结果格拉斯哥预后评分判断:良好1269例(64%),中残175例(9%),重残116例(6%),植物生存39例(2%),死亡377例(19%)。在死亡377例中,死于院前139例(37%),死于院内238例(63%);死于伤后1h以内98例(26%),24h以内117例(31%),24h以上162例(43%)。结论道路交通伤具有创伤因素多,创伤重,变化快,多伴复合伤、多发伤、预后差的特点。院前急救是抢救成功的关键,院前院内一体化急救是交通伤的有效救护模式。Objective To discuss the integrated mode and the effect of pre- and in-hospital rescue on severe road traffic injuries （SRTI）. Methods The medical practice of a pre-hospital aid station with 4 members and medical teams with 4, 8, 12 and 48 members between January 2006 and October 2010 were reviewed. A total of 1976 cases with SRTI in 510 traffic accidents were rescued. The patients accepted on-site classification, cardiac pulmonary cerebral resuscitation, emergency operation, rapid evacuation to the hospital, and in-hospital emergency treatment, surgical operation and post-operation management. The therapeutic effects were observed. Results According to the Glasgow coma scale, 1269 cases （64%） were evaluated as good, 175 cases （9%） middle disability, 116 cases（6%） severe disability, 39 cases （2%） persistent vegetative state （PVS）,and 377 cases （23%） death. In 377 death cases, 139 cases died in pre-hospital （37%）, 238 died in the hospital （63%）, 98 died in 1 hour after injury （25%）, 117 died in 24 hours （31%）, and 162 died over 24 hours after injury （43%）. Conclusion The main clinical characteristics of SRTI are various injury factors, severity of injuries, rapid disease development, multiple and complex traumas and bad prognosis. The early pre-hospital emergency rescue is crutial. Integrated pre- and in-hospital first-aid is an effective rescue mode of SRTI and possesses of popularization and application value.

关 键 词：严重交通伤 大批伤病员 院前与院内救护 院前医疗站 应急医疗队 急救模式 

分 类 号：R651.15[医药卫生—外科学] R195.1[医药卫生—临床医学]