优化院前急救网络对严重创伤患者救治的影响  

Optimization of emergency medical serve system and its effect on the emergency treatment of patients with severe trauma

作　　者：张峰海[1] 武卫[1] 郑旭东[1] 

机构地区：[1]温州医科大学附属第三医院(瑞安市人民医院)急救中心,浙江省瑞安市325200

出　　处：《中华全科医学》2015年第6期881-884,共4页Chinese Journal of General Practice

基　　金：原卫生部卫生公益性行业科研专项课题(2010-02014)

摘　　要：目的研究优化改造院前急救网络对严重创伤患者救治效果及社会效益的影响。方法选择于2012年10月19日—2013年10月19日期间经120急救车辆接送收治入院,有明显外伤史,符合严重创伤(ISS≥16分)标准的217例患者作为对照组;此后对120急救网络进行了优化改造,包括:1成立全市统一的急救调度指挥中心;2增设8个急救站;3乡镇医院医师经培训担任分站急救转运任务;4改善救护车配备设备;5增设无线网络;6加强急救制度的建设等。优化后于2013年10月20日—2014年10月20日收集符合严重创伤(ISS≥16分)标准的206例患者作为研究组。比较2组呼救到达时间(min)、院前急救时间(min)、28 d病死率的差异,并进行统计分析。结果网络优化后组的呼救到达时间、院前急救时间、28 d病死率(11.88±2.38、37.50±5.95、4.85%)均小于网络优化前(27.37±4.83、53.68±8.72、10.60%),差异均有统计学意义(P<0.05)。结论优化120院前急救网络可以缩短严重创伤患者的呼救到达时间和院前急救时间,降低28 d病死率,具有较好的社会效益。Objective To study the optimization of emergency medical serve system（EMSS） and its effect on the emer- gency treatment of patients with severe trauma and social efficiency. Methods 217 emergency patients with severe trau- ma patients（ISS≥16） before the optimization of EMSS（ control group） and 206 emergency patients with severe trauma patients （ISS ≥ 16 ） after the optimization of E MSS （study group） were enrolled in this study from 2012 to 2014. The im- proved services included： setting up the union emergency dispatch center of the whole city ; building other 8 emergency u- nits;the trained township hospital physicians were incorporated as new unit members;increasing more advanced instruc- tions in emergency cars;setting up wireless nets ; strengthening the building of emergency system. The responsive times （ min）, pre-hospital times （min） and 28-day mortality were compared between the two group. Results After the optimiza- tion of EMSS, the emergency responsive time and pre-hospital time in the study group were shorted as compared with the control group（P〈0.05 ）, And the 28-day mortality of the study group was lower than that of the control group（ P 〈 0.05 ）. Conclusion The optimization of EMSS can short the emergency responsive time and pre-hospital times, decrease the 28-day mortality, with better medical results and social efficiency.

关 键 词：优化120急救网络 呼救到达时间 院前急救时间 严重创伤 

分 类 号：R459.7[医药卫生—急诊医学] R641[医药卫生—治疗学]