腹主动脉瘤破裂患者急诊紧急处理的流程优化  

Process optimization of emergency treatment for patients with ruptured abdominal aortic aneurysm

作　　者：李淑娇 牛鹿原[2] 王艳平 Li Shujiao;Niu Luyuan;Wang Yanping(Department of Emergency,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Vascular Surery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院急诊科,北京100038 [2]首都医科大学附属北京世纪坛医院血管外科,北京100038

出　　处：《血管与腔内血管外科杂志》2023年第1期49-53,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨急诊紧急处理的流程优化对住院期间腹主动脉瘤破裂患者的影响。方法收集2017年2月至2021年12月首都医科大学附属北京世纪坛医院急诊接诊的120例腹主动脉瘤破裂患者的临床资料。本院自2019年7月开始对腹主动脉瘤破裂患者急诊处理流程进行优化,将实施优化流程前设为对照组(n=53)、实施优化流程后设为优化组(n=67)。比较两组患者在院期间病死率、并发症发生率、发病到急诊时间、急诊到确诊时间、确诊到手术时间、术中出血量、术中输血量。结果优化组患者急诊到确诊时间、确诊到手术时间均短于对照组患者,差异均有统计学意义(P﹤0.05)。优化组患者在院期间病死率、并发症总发生率均低于对照组患者,差异均有统计学意义(P﹤0.05)。优化组患者术中出血量、术中输血量均明显少于对照组患者,手术时间均明显短于对照组患者,差异均有统计学意义(P﹤0.01)。结论优化腹主动脉瘤破裂患者急诊紧急处理的流程可明显缩短患者确诊所需要的时间及手术等待时间,使患者得到及时救治,从而降低了患者在院期间的病死率和并发症总发生率。Objective To analyze the impact of emergency treatment process optimization on the in-hospital outcome of patients with ruptured abdominal aortic aneurysm.Method A total of 120 patients with ruptured abdominal aortic aneurysm who were treated in Beijing Shijitan Hospital,Capital Medical University from February 2017 to December 2021 were selected.The emergency treatment of ruptured abdominal aortic aneurysm was optimized from July 2019,according to optimization,the patients were divided into control group(n=53,before the implementation of the optimization process)and the optimization group(n=67,after the implementation of the optimization process)The mortality in hospitalization,incidence of complications,the time from onset to emergency treatment,the time from emergency to definite diagnosis,the time from emergency to operation,intraoperative blood loss,and blood transfusion were compared between two groups.Result The time from emergency to definite diagnosis and the time from diagnosis to operation in the optimization group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The mortality in hospitalization and incidence of complications in the optimization group were lower than those in the control group,the differences were statistically significant(P<0.05).The intraoperative blood loss,intraoperative blood transfusion and operation time in the optimization group were significantly lower than those in the control group,the differences were statistically significan(P<0.01).Conclusion Optimizing the emergency treatment process of patients with ruptured abdominal aortic aneurysm can significantly shorten the time required for diagnosis and the waiting time for surgery,so that patients can be treated in time,thus reducing the mortality and total incidence of complications of patients in hospital.

关 键 词：腹主动脉瘤 急诊 流程 并发症 

分 类 号：R543[医药卫生—心血管疾病]