创伤链式抢救流程对创伤失血性休克患者复苏效果及死亡率的影响  

Effect of traumatic chain rescue procedure on resuscitation and mortality in patients with traumatic hemorrhagic shock

作　　者：陈懋[1] 李峥 杨林[1] 张红[1] 杨静[1] CHEN Mao1 , LI Zheng2, YANG Lin1 , ZHANG Hong1 , YANG Jing1(l. Department of Emergency, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610599, China ; 2.Department of Anesthesia, Chengdu Xindu Hospital of Traditional Chinese Medicine, Chengdu 610500, Chin)

机构地区：[1]成都医学院第一附属医院急诊科,四川成都610599 [2]成都市新都区中医院麻醉科,四川成都610500

出　　处：《西部医学》2018年第4期526-529,共4页Medical Journal of West China

基　　金：四川省卫生厅科研课题(100097)

摘　　要：目的探讨创伤链式抢救流程对创伤失血性休克患者复苏效果及死亡率的影响。方法选择2016年1月~2016年12月在我院接受治疗的创伤失血性休克患者90例为研究对象,随机分为观察组与对照组,每组各45例。观察组应用创伤链式抢救流程,对照组应用常规急救流程。观察两组有效救治时间、休克纠正时间、术后72h日输液量、液体复苏达标时间、住院时间、器官损伤及功能障碍发生情况以及抢救结果。结果观察组伤后送达病房救治时间、休克纠正时间、术后72h日输液量、液体复苏达标时间及住院时间均少于对照组,差异具有统计学意义(P<0.05);与对照组比较,观察组器官损伤及功能障碍发生率更低,差异具有统计学意义(28.89%vs 8.89%,P<0.05);观察组好转率高于对照组,观察组无变化发生率和死亡率均低于对照组,差异具有统计学意义(均P<0.05)。结论创伤失血性休克患者运用创伤链式抢救流程能有效缩短抢救时间,提高复苏效果和抢救成功率,有助于提高抢救效果及改善预后,可在临床推广应用。Objective To investigate the effect of traumatic chain rescue procedure on resuscitation and mortality in patients with traumatic hemorrhagic shock. Methods 90 patients with traumatic hemorrhagic shock treated in our hospital from January 2016 to December 2016 were randomly divided into observation group and control group. There were 45 cases in each group. The patients in the observation group were treated with trauma chain rescue procedure, and the control group applied the conventional emergency procedure. The time of effective treatment, the time of shock recovery, the infusion volume, the time of fluid resuscitation, the time of hospitalization, the occurrence of organ damage and the occurrence of dysfunction and the result of rescue were observed. Results The time of treatment, the time of shock recovery, the infusion volume, the time of fluid resuscitation and the time of hospitalization （29.24 ± 5.72rain, 8.09 ±2.01 h, 2981.85 ± 520.62 ml, 2.98 ± 0.74, respectively） were significantly lower than those in the control group （20.28 ± 5.91min, 6.27 ± 1.25 h, 2156.84 ± 361.27ml, 2.47 ± 0.62 h, 47.15 ± 13.29d） H, 59.34 ± 15.61d） （P〈0.05）. The incidence of organ damage and dysfunction in the observation group （8.89 % ） was significantly lower than that of the control group （28.89%） （P〈0.05）. The improvement rate of patients in the observation group （91.11） was higher than that in the control group （64.44%）. The incidence and mortality in the observation group （6.67%, 2.22%） were lower than those in the control group （22.22%, 13.33%） （P〈0.05）. Conclusion Traumatic hemorrhagic shock patients with traumatic chain rescue process can effectively shorten the rescue time and improve the recovery effect and rescue suc- cess rate. It is helpful to improve the effect of rescue and improve the prognosis.

关 键 词：链式抢救流程 创伤 失血性休克 复苏效果 死亡率 

分 类 号：R619.5[医药卫生—外科学]