创伤救治中心建设前后严重多发伤患者救治效果比较  

Effect of construction of trauma care center on treatment of patients with severe multiple trauma

作　　者：杨鹏[1] 陈恒峰 王龙刚 夏军 郭凤宝 张晓飞 陈都[1] 陈雄辉[1] 凌伟华[1] 徐峰[1] Yang Peng;Chen Hengfeng;Wang Longgang;Xia Jun;Guo Fengbao;Zhang Xiaofei;Chen Du;Chen Xionghui;Ling Weihua;Xu Feng(Department of Emergency Surgery, First Affiliated Hospital of Soochow University, Suzhou 215000, China)

机构地区：[1]苏州大学附属第一医院急诊外科,215000

出　　处：《中华创伤杂志》2019年第10期913-917,共5页Chinese Journal of Trauma

基　　金：国家自然科学基金(81701213);江苏省自然科学基金(BK20170369);苏州市科技计划项目(SYS201616);姑苏卫生人才培养项目(GSWS2019037).

摘　　要：目的探讨江苏省省级创伤救治中心建设前后严重多发伤患者的救治效果。方法采用回顾性病例对照研究分析2015年12月— 2017年11月苏州大学附属第一医院收治的412例严重多发伤患者的临床资料,其中男250例,女162例;年龄19~80岁[(45.8±15.9)岁]。损伤严重度评分(ISS)18~57分[(28.2±9.3)分]。以江苏省省级创伤救治中心建设单位成立后救治的211例患者为观察组,省级创伤救治中心建设前救治的201例患者为对照组。比较两组患者到达医院后至开始抢救的时间、从就诊到完成CT检查的时间、从提出输血申请到护士执行输血的时间、抢救室滞留时间、病死率。结果观察组开始抢救时间[(2.5±1.7)min]、完成CT检查时间[(36.2±11.6)min]、输血时间[(28.7±11.3)min]、抢救室滞留时间[(3.0±2.0)h]均明显短于对照组[(5.4±2.6)min、(53.2±12.9)min、(46.5±14.1)min、(5.0±2.8)h](P<0.05或0.01);观察组病死率[3.8%(8/211)]明显低于对照组[8.5%(17/201)](P<0.05)。结论创伤救治中心建设能有效缩短严重多发伤患者的救治时间,降低患者的病死率,提高救治效果,值得进一步推广。Objective To investigate the effect of construction of trauma care center on the treatment of patients with severe multiple trauma. Methods A retrospective case control study was conducted to analyze the clinical data of 412 patients with severe multiple trauma admitted to the First Affiliated Hospital of Soochow University from December 2015 to November 2017. There were 250 males and 162 females, aged 19-80 years [(45.8±15.9)years]. The injury severity score (ISS) ranged from 18 to 57 points [(28.2±9.3)points]. The observation group included 211 patients who were treated after the establishment of the provincial trauma treatment center in Jiangsu Province, and the control group included 201 patients who were treated before the establishment of the provincial trauma treatment center. The durations from arrival to the start of rescue, from consultation to completion of CT examination, from applying for blood transfusion to the execution of blood transfusion by nurses, the time of stay at the resuscitation room and the mortality rate were compared between the two groups. Results The observation group presented better results in the durations from arrival to the start of rescue [(2.5±1.7)minutes vs.(5.4±2.6)minutes], from the start of the rescue to completion of CT scan [(36.2±11.6)minutes vs.(53.2±12.9)minutes], the transfusion time [(28.7±11.3)minutes vs.(46.5±14.1)minutes], and the time of stay at resuscitation room [(3.0±2.0)hours vs.(5.0±2.8)hours](P<0.05 or 0.01). The mortality rate in the observation group was 3.8%(8/211), which was significantly lower than 8.5%(17/201) in control group (P<0.05). Conclusion The construction of trauma treatment center can effectively shorten the treatment time of patients with severe multiple trauma, reduce the mortality rate and improve the efficacy, which is worthy of promotion.

关 键 词：创伤诊治中心 多处创伤 损伤严重度评分 病死率 

分 类 号：R641[医药卫生—外科学]