创伤中心救治一体化对严重多发伤急诊手术患者的救治疗效观察  

Effect of integrative trauma center care on the treatment of severe multiple injuries patients with emergency surgery

作　　者：马汤力 王绍谦 张冬惠 胡瑞玲 Ma Tangli;Wang Shaoqian;Zhang Donghui;Hu Ruiling(Department of Emergency,Kaifeng People s Hospital,Kaifeng,Henan Province 475000,China)

机构地区：[1]开封市人民医院急诊科,河南开封475000

出　　处：《创伤外科杂志》2023年第12期934-938,共5页Journal of Traumatic Surgery

基　　金：河南省开封市科技发展计划项目(2204086)。

摘　　要：目的探讨创伤中心救治一体化对严重多发伤急诊手术患者的救治效果。方法回顾性分析2021年1月—2023年3月开封市人民医院急诊科收治的严重多发伤(ISS≥16分)急诊手术患者140例。以2022年3月—2023年3月开封市人民医院创伤中心成立后一体化救治的75例患者为观察组,2021年1月—2022年1月创伤中心成立前救治的65例患者为对照组。比较两组患者入院时间、急会诊医师到位时间、患者抢救室入出时间、影像检查时间、术前等待时间、EICU治疗时间、多器官功能障碍综合征和休克的发生率、病死率等。结果观察组入院时间(42.5±13.3)min、急会诊医师到位时间(3.7±1.6)min、患者抢救室入出时间(105.5±35.7)min均短于对照组[(47.2±10.3)min、(5.9±1.8)min、(135.3±38.6)min],差异有统计学意义(P<0.05)。观察组影像检查时间(21.1±7.2)min、术前等待时间(32.6±12.2)min、EICU住院日(9.5±3.8)d均短于对照组[(40.1±7.2)min、(69.1±10.1)min、(13.5±4.8)d],差异有统计学意义(P<0.001)。观察组休克发生率5.3%,多器官功能障碍综合征发生率9.3%,病死率4.0%,均低于对照组(18.4%、24.6%、15.4%),差异有统计学意义(P<0.05)。结论加强创伤中心救治一体化建设能够有效缩短严重多发伤患者的救治时间,术前等待时间也显著减少。此外患者的重症监护住院日减少,严重并发症和病死率也下降,有效提高了严重多发伤急诊手术患者的抢救效率,为临床创伤救治提供了参考。Objective To investigate the therapeutic effect of the integrative trauma center care on severe multiple injuries patients undergoing emergency surgery.Methods The inpatient clinical data of 140 patients with severe multiple injuries(ISS≥16)were retrospectively analyzed,who were admitted from Jan.2021 to Mar.2023 in Department of Emergency,Kaifeng People’s Hospital.There were 78 males and 62 females,aged 18-65 years,with an average age of 35.9 years.The 75 patients who were treated in an integrated manner from Mar.2022 to Mar.2023 after the establishment of the Trauma Center of Kaifeng People’s Hospital were taken as the observation group,and 65 patients treated from Jan.2021 to Jan.2022 before the establishment of the Trauma Center were taken as the control group.The admission time,emergency consultation physician arrival time,time from entry to exit in emergency room,imaging examination time,preoperative waiting time,EICU treatment time,incidence and mortality of multiple organ dysfunction syndrome and shock were compared between the two groups.Results The admission time of patients in the observation group(42.5±13.3)min,the arrival time of emergency physicians(3.7±1.6)min,and the time from entry to exit in emergency room(105.5±35.7)min were shorter than that in the control group[(47.2±10.3)min,(5.9±1.8)min,(135.3±38.6)min],and the differences were statistically significant(P<0.05).The imaging examination time(21.1±7.2)min,preoperative waiting time(32.6±12.2)min,and EICU hospitalization day(9.5±3.8)d were shorter than that in the control group[(40.1±7.2)min,(69.1±10.1)min,(13.5±4.8)d],and the differences were statistically significant(P<0.001).The incidence of shock in the observation group was 5.3%,the incidence of multiple organ dysfunction syndrome was 9.3%,and the mortality rate was 4.0%,which were lower than those in the control group(18.4%,24.6%,15.4%),and the differences were statistically significant(P<0.05).Conclusion Strengthening the integrative construction of trauma center can eff

关 键 词：多发伤 创伤中心 救治一体化 术前等待时间 

分 类 号：R605.97[医药卫生—急诊医学]