急诊一体化模式在创伤救治中的临床分析  

Effectiveness of an integrated emergency care mode in the treatment of patients with multiple injuries

作　　者：周礼鹏 江甜甜[2] 王婧斐 Zhou Li-peng;Jiang Tian-tian;Wang Jing-fei(Emergency Department,Taizhou Central Hospital(Taizhou University Hospital),Taizhou 318000,China;不详)

机构地区：[1]台州市中心医院(台州学院附属医院)急诊科,浙江台州318000 [2]台州市中西医结合医院消化内科,浙江台州317523

出　　处：《中国急救医学》2023年第2期109-112,共4页Chinese Journal of Critical Care Medicine

基　　金：浙江省教育厅一般科研项目和思政专项项目(Y202044196)。

摘　　要：目的探讨急诊一体化救治模式在以严重胸部损伤为主的多发伤患者救治中的应用效果。方法选取本院急诊科收治的108例以严重胸部损伤为主的多发伤患者作为研究对象,根据患者救治模式的不同分为两组:对照组(n=50)采用既往的专科救治模式,观察组(n=58)采用急诊一体化救治模式。对比两组的院内急诊时间、入院-确定性治疗启动时间、ICU住院时间、总住院时间、病死率及入院2周损伤严重程度、出院后3个月预后情况等。结果观察组早期病死率及休克、MODS发生率均明显低于对照组,抢救成功率明显高于对照组(P<0.05)。观察组院内急诊时间明显较对照组长,入院-确定性治疗启动时间、ICU住院时间、总住院时间均明显较对照组短(P<0.05)。两组入院2周的损伤严重程度均较抢救前明显减轻,并且观察组入院2周的轻伤占比明显高于对照组,严重伤占比明显低于对照组(P<0.05)。随访显示,出院后3个月观察组重残率、植物生存率及病死率均明显低于对照组(P<0.05)。结论对以严重胸部损伤为主的多发伤患者实施急诊一体化救治,能够提高多发伤救治的系统性、连续性及整体性,可尽快启动确定性治疗,控制损伤,提高救治效果,改善患者预后。Objective To explore the application effect of the integrated emergency treatment mode in the treatment of patients with multiple injuries,mainly severe chest injuries.Methods 108 cases of multiple injuries with severe chest injury were divided into two groups according to the different treatment methods.The control group(50 cases)used the previous specialized treatment mode,and the observation group(58 cases)used the integrated emergency treatment mode.The inpatient emergency time,admission-determining treatment initiation time,ICU hospitalization time,total hospitalization time,and mortality were compared between the two groups.Results The early mortality,the incidence of shock and MODS were significantly lower in the observation group than in the control group,and the rescue success rate was significantly higher than in the control group(P<0.05).The inpatient emergency time in the observation group was significantly longer than that in the control group,and the admission-determining treatment initiation time,ICU hospitalization time,and total hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05).The severity of the injuries in the two groups after 2 weeks of admission was significantly lighter than before the rescue,and the proportion of minor injuries in the observation group was significantly higher than that in the control group,and the proportion of serious injuries was significantly lower than that in the control group(P<0.05).Follow up showed that the severe disability rate,vegetative survival rate and mortality rate in the observation group were significantly lower than those in the control group 3 months after discharge(P<0.05).Conclusion The implementation of integrated emergency treatment for multiple trauma patients mainly with severe chest injury can improve the systematicness,continuity and integrity of multiple trauma treatment,start deterministic treatment as soon as possible,control the injury,improve the treatment effect and the progno

关 键 词：急诊 一体化救治模式 多发伤 胸部损伤 专科救治模式 

分 类 号：R641[医药卫生—外科学]