以EICU为平台的创伤中心救治严重多发伤患者的临床分析  

Clinical analysis of treating severe and multiple trauma patients by trauma center using EICU as platform

作　　者：叶方[1] 杨志军[1] 马继民[1] 晋小祥[1] YE Fang;YANG Zhijun;MA Jimin;JIN Xiaoxiang(Department of Emergency Medical Center,Maanshan General Hospital of Ranger-Duree Healthcare Former,Maanshan Cental Hospital,Maanshan,Anhui,243000,China)

机构地区：[1]德驭医疗马鞍山总医院(原马鞍山市中心医院)急诊医学中心,安徽马鞍山243000

出　　处：《临床急诊杂志》2022年第11期770-773,780,共5页Journal of Clinical Emergency

基　　金：马鞍山市科技局医疗卫生领域项目(No:YL-2020-15)。

摘　　要：目的:通过以EICU为平台的创伤中心救治严重多发伤患者的临床效果分析,探讨提高严重多发伤预后的急救模式。方法:采用回顾性病例对照研究分析211例严重多发伤患者的临床资料,其中2016年10月-2018年9月期间采用多学科会诊模式救治的103例严重多发伤患者作为对照组,2020年9月—2022年4月期间收治的108例采用以EICU为平台的创伤中心救治模式救治的严重多发伤患者作为研究组。观察比较两组的急诊救治时间、完成初次检查时间、抢救厅滞留时间、急诊手术时间以及两组患者的预后、两组合并重度颅脑损伤患者的预后。结果:研究组急诊救治时间[(5.8±1.9) min]、完成初次检查时间[(31.3±12.2) min]、抢救厅滞留时间[(86±37) min]、急诊手术时间[(122±56) min]均明显短于对照组[(9.6±2.3) min]、[(52.7±14.6) min]、[(145±62) min]、[(182±78) min],差异有统计学意义(P<0.05);研究组病死率明显低于对照组,差异有统计学意义(P<0.05);研究组合并颅脑损伤患者病死率明显低于对照组,差异有统计学意义(P<0.05)。结论:以EICU为平台的创伤中心救治模式能有效地缩短严重多发伤的救治时间,降低严重多发伤患者包括合并重度颅脑损伤患者的病死率,值得临床推广及进一步研究探索。Objective: To explore the first aid mode to improve the prognosis of severe multiple trauma by analyzing the clinical effects of trauma center using EICU as platform in treating severe multiple trauma patients. Methods: A retrospective case-control study was made to analyze the clinical data of 211 patients with severe multiple trauma within two years before and after September 2020. Among them, 103 before September 2020 who were treated by multidisciplinary consultation were taken as control group, and 108 after September 2020 who were treated in EICU-led trauma center were taken as study group. The time of emergency treatment, the time to complete the initial examination, the time of staying in the rescue hall, the time of emergency operation, the prognosis of the patients in the two groups, and the prognosis of the patients with severe craniocerebral injury in the two groups were observed and compared. Results: The time of emergency treatment[(5.8±1.9) min], the time to complete the initial examination[(31.3±12.2) min], the time of staying in the emergency room[(86±37) min], and the time of emergency operation[(122±56) min]in the study group were significantly shorter than those in the control group[(9.6±2.3) min], [(52.7±14.6) min], [(145±62) min], [(182±78) min].The mortality rate of the study group was significantly lower than that of the control group(P<0.05), and the mortality rate of the patients with craniocerebral injury in the study group was significantly lower than that of the control group(P<0.05). (P<0.05). Conclusion: The trauma center using EICU as platform can effectively shorten the treatment time of severe multiple injuries and reduce the mortality of patients, especially of those with severe craniocerebral injury, which is worthy of promotion and further exploration.

关 键 词：严重多发伤 多学科模式 创伤中心 预后 

分 类 号：R459.7[医药卫生—急诊医学]