我国医生对严重创伤评估能力的多中心调查  

A multicenter survey of doctors’ability to assess severe trauma in China

作　　者：张鹏[1,2,3] 杜哲 刘中砥[1,2,3] 黄伟 张亚军[1,2,3] 王天兵[1,2,3,4] Zhang Peng;Du Zhe;Liu Zhongdi;Huang Wei;Zhang Yajun;Wang Tianbing(Trauma Center,Peking University People's Hospital,Beijing 100044,China;National Center for Trauma Medicine,Beijing 100044,China;Key Laboratory of Trauma and Neural Regeneration(Peking University),Ministry of Education,Beijing 100044,China;Department of Trauma and Orthopaedics,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院创伤救治中心,100044 [2]国家创伤医学中心,北京100044 [3]创伤救治与神经再生教育部重点实验室,北京100044 [4]北京大学人民医院创伤骨科,100044

出　　处：《中华急诊医学杂志》2021年第5期533-536,共4页Chinese Journal of Emergency Medicine

基　　金：北京大学临床科学家计划专项(中央高校基本科研业务费资助)(BMU2019LCKXJ005);北京大学医学部-密歇根大学医学院转化医学与临床研究联合研究所(中央高校基本科研业务费资助)(BMU2020JI007);国家重点研发计划(2018YFF0301103);国家自然科学基金(31771326);北京市自然科学基金(7204321)。

摘　　要：目的了解我国不同地域、不同级别医院医生对严重创伤患者损伤程度的评估能力。方法2018年11月至2020年5月选取中国创伤救治联盟38家研究中心(三级、二级医院各19家,其中东西部医院分别为20、18家),每家中心选取急诊外科初、中、高级医师各2名,对10例严重创伤患者进行创伤严重程度评分(injury severity score,ISS),分析评分合格率。结果初、中、高级医师评分合格率分别为56.05%、56.18%、56.71%,差异无统计学意义(P>0.05),三级医院和二级医院评分合格率分别为63.07%和49.56%,差异有统计学意义(P<0.01),东西部医院评分合格率分别为67.00%和44.44%,差异有统计学意义(P<0.01)。结论我国医生对于严重创伤患者的伤情评估总体水平令人满意,但仍存在医院级别和地域间的差异。今后要重视基层医院的培训和体系建设,积极扶持西部地区医院的建设和发展,尽早实现我国创伤救治的标准化和规范化。Objective To investigate the ability of doctors in different regions and levels of hospitals in assessing the severity of severe trauma in China.Methods A total of 38 trauma centers of China Trauma Rescue&Treatment Association(19 tertiary hospitals and 19 secondary hospitals,including 20 eastern and 18 western hospitals)were selected from November 2018 to May 2020.Two junior,two middle,and two senior emergency surgeons were selected in each center.Injury severity score(ISS)was performed on 10 patients with severe trauma,and the qualified rate was analyzed.Results The qualified rates of junior,middle,and senior doctors were 56.05%,56.18%,and 56.71%,respectively(P>0.05).The qualified rates of tertiary and secondary hospitals were 63.07%and 49.56%,respectively(P<0.01).The qualified rates of eastern and western hospitals were 67.00%and 44.44%,respectively(P<0.01).Conclusions The overall level of injury assessment of severe trauma patients by doctors in China is satisfactory,while there are still differences in hospital levels and regions.In the future,attention should be paid to the training and system construction in primary hospitals.We should actively support the construction and development of hospitals in the western regions and realize the standardization of trauma treatment in China as soon as possible.

关 键 词：严重创伤 创伤严重程度评分 多发伤 检伤分类 创伤救治体系 

分 类 号：R641[医药卫生—外科学]