36例心脏危重症患者直升机医疗转运管理  

Management of helicopter medical transport in 36 patients with critical cardiac disease

作　　者：郑改改 杨巧芳[1] 于漫[1] 马凌燕[2] 吴娜[3] 田焕[4] 殷月 Zheng Gaigai;Yang Qiaofang;Yu Man;Ma Lingyan;Wu Na;Tian Huan;Yin Yue(Department of Nursing,the Heart Center of Henan Provincial People's Hospital,Fuwai Central China Cardiovascular Disease Hospital,Huazhong Fuwai Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China;Department of Cardiovascular Care Unit,the Heart Center of Henan Provincial People's Hospital,Fuwai Central China Cardiovascular Disease Hospital,Huazhong Fuwai Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China;Department of Extracardiac Intensive Care Unit,the Heart Center of Henan Provincial People's Hospital,Fuwai Central China Cardiovascular Disease Hospital,Huazhong Fuwai Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China;Department of Heart Failure,the Heart Center of Henan Provincial People's Hospital,Fuwai Central China Cardiovascular Disease Hospital,Huazhong Fuwai Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China;Disinfection Supply Center,Henan Provincial People's Hospital,Zhengzhou 450000,Henan,China)

机构地区：[1]河南省人民医院心脏中心,阜外华中心血管病医院,郑州大学华中阜外医院护理部,郑州450000 [2]河南省人民医院心脏中心,阜外华中心血管病医院,郑州大学华中阜外医院CCU,郑州450000 [3]河南省人民医院心脏中心,阜外华中心血管病医院,郑州大学华中阜外医院心外ICU,郑州450000 [4]河南省人民医院心脏中心,阜外华中心血管病医院,郑州大学华中阜外医院心衰科,郑州450000 [5]河南省人民医院消毒供应中心,郑州450000

出　　处：《中华危重病急救医学》2023年第2期201-205,共5页Chinese Critical Care Medicine

基　　金：河南省医学科技攻关计划省部共建项目(SB201901100);河南省医学科技攻关计划联合共建项目(LHGJ20190769,LHGJ20200115);河南省人民医院"23456"人才工程培养重点项目(2017-176-1)。

摘　　要：目的总结心脏危重症患者使用直升机进行医疗转运的管理经验,为在重大自然灾害背景下危重症患者转运提供借鉴。方法收集2021年7月21日16:30至7月22日19:30阜外华中心血管病医院因历史罕见特大暴雨使用直升机转运的36例心脏危重症患者的临床及转运资料。在迅速组建转运领导协调组、明确职责及分工,做好患者病情、管道评估及机械循环辅助(MCS)设备的预处理,模拟演练转运流程,提高转运实施过程的安全性,与目标医院进行有效交接等的完备措施下,采用直升机对心脏危重症患者实施转运。收集患者的性别、年龄、病种、MCS情况、转运情况及转归。结果36例心脏危重症患者分别来自成人心外重症监护病房(ICU)、成人心脏重症监护病房(CCU)、儿童CCU、综合ICU和神经疾病科;其中,男性24例,女性12例;年龄(50.93±20.86)岁;12例患者使用呼吸机,7例患者需要MCS设备支持〔其中2例既需要体外膜肺氧合(ECMO),又需要主动脉内球囊反搏(IABP)支持〕,7例患者为心脏术后。36例患者转运总距离1638.4 km,共历时10.5 h,直升机单程空中飞行时间约8 min,每位患者平均转运用时约17.5 min。36例患者转运途中生命体征基本稳定,未发生转运相关不良事件,均安全到达目标医院。结论在迅速组建转运领导协调组、评估患者病情及预处理、模拟演练转运流程、与接收医院有效交接等各环节的无缝衔接下,使用直升机对心脏危重症患者进行医疗转运具有可行性和安全性,可为拯救患者生命和进一步救治争取宝贵时间。Objective To summarize the management experience of helicopter medical transport in patients with critical heart disease,so as to provide reference for transport of patients with critical heart disease under the background of major natural disasters.Methods The clinical and transport data of 36 critically ill cardiac patients in Fuwai Central China Cardiovascular Hospital from 16:30 on July 21 to 19:30 on July 22,2021 due to historically rare heavy rainstorms were collected.All 36 critically ill cardiac patients were transported by helicopter.The safe transportation was implemented under the measures of quickly forming a transport leadership and coordination group,clarifying responsibilities and division of labor,doing a good job in the pretreatment of the patient's condition,pipeline assessment and mechanical circulation support(MCS)equipment,simulating and practicing the transfer process,improving the safety of the transfer implementation process,and effectively handing over with the target hospital.The gender,age,disease type,MCS,transport and outcome of patients were collected.Results Thirty-six patients with cardiac critical illness were from adult extracardiac intensive care unit(ICU),adult cardiac care unit(CCU),children's CCU,comprehensive ICU and department of neurology.There were 24 males and 12 females;age(50.93±20.86)years old.There were 12 patients using respirator,7 patients needing MCS,2 of whom needed both extracorporeal membrane oxygenation(ECMO)and intra-aortic balloon pump(IABP),and 7 patients with post-cardiac surgery.The total distance of transportation of 36 patients was 1638.4 km,the transit time was 10.5 hours,one way flight time of helicopter was about 8 minutes,and the average transport time per patient was about 17.5 minutes.The vital signs of 36 patients during transport were basically stable,without complications,and all of them reached the target hospital safely.Conclusion Under the seamless connection of the rapid establishment of the transfer leadership coordination group,assessme

关 键 词：重大自然灾害 重症 心血管疾病 直升机 航空转运 医疗救援 

分 类 号：R459.7[医药卫生—急诊医学]