创伤一体化救治模式探讨及其对严重创伤患者预后的影响  

Exploration of integrated trauma treatment model and its impact on the prognosis of severe trauma patients

作　　者：张冠军 邹静蓉 祁航 李文健 张巍 Zhang Guanjun;Zou Jingrong;Qi Hang(ICU,Wuxi Huishan District People′s Hospital,Wuxi 214000,China)

机构地区：[1]无锡市惠山区人民医院重症医学科,214000 [2]无锡市惠山区人民医院急诊科,214000

出　　处：《中华保健医学杂志》2024年第1期94-96,共3页Chinese Journal of Health Care and Medicine

基　　金：无锡市科协软科学研究课题(KX-21-C249)。

摘　　要：目的观察采用创伤一体化救治模式救治严重创伤患者的效果。方法选取无锡惠山区人民医院2019年1月~2021年5月期间采用传统模式救治的92例严重创伤患者为对照组,2021年6月~2023年3月采用创伤一体化模式救治的83例患者为一体化组。对照组采用传统的急诊分流专科治疗模式,一体化组采用团队一体化救治模式,并相应完善硬件配置及辅助环节。比较两组患者来院后急诊整体治疗处置时间、接受急诊手术患者来院至手术时间、平均住院时间;比较两组患者28 d死亡率;比较两组患者多器官功能障碍综合征(MODS)、弥散性血管内凝血(DIC)等并发症发生率。结果一体化组的急诊整体治疗处置时间明显长于对照组[(5.26±0.65)h vs.(2.13±0.88)h],接受急诊手术患者来院至手术时间明显低于对照组[(1.28±0.37)h vs.(2.35±0.46)h],差异有统计学意义(t=26.524、16.838,P=0.000);一体化组住院时长低于对照组[(14.79±4.85)d vs.(16.24±5.16)d],但差异无统计学意义(t=1.909,P=0.058)。一体化组死亡率低于对照组(7.23%vs.18.48%),差异有统计学意义(t=4.837,P=0.028)。一体化组MODS发生率低于对照组(8.43%vs.21.74%),差异有统计学意义(t=5.920,P=0.014);两组间DIC发生率(4.82%vs.11.96%)差异无统计学意义(t=2.836,P=0.092)。结论创伤一体化救治模式能缩短多发伤患者急诊处置时间,降低死亡率和MODS发生率,改善患者预后。Objective To observe the effectiveness of using an integrated trauma treatment model to treat severe trauma patients.Methods A total of 92 severe trauma patients treated with traditional mode from January 2019 to May 2021 were included in the control group,and 83 patients treated with integrated trauma mode from June 2021 to March 2023 were included in the integrated group.The control group adopts the traditional emergency diversion specialized treatment mode,while the integrated group adopts the team integrated treatment mode,and correspondingly improves the hardware configuration and auxiliary links.The emergency overall treatment time,average hospital stay,28-day mortality rate,incidence of multiple organ dysfunction syndrome(MODS),and disseminated intravascular coagulation(DIC)between the two groups of patients were compared.Results The emergency overall treatment time of the integrated group was significantly longer than that of the control group,while the time spent by patients receiving emergency surgery from hospital to surgery was significantly lower than that of the control group,with a statistically significant difference(t=26.524,16.838,P<0.05).The hospitalization time of the integrated group was lower than that of the control group,but there was no significant difference(t=1.909,P=0.058).The mortality rate in the integrated group were lower than those in the control group,with a statistically significant differences(t=4.837,P=0.028).The incidence of MODS in the integrated group was significantly lower than that in the control group(t=5.920,P=0.014),but there was no significant difference in the incidence of DIC between the two groups(t=2.836,P=0.092).Conclusion The integrated trauma treatment model can shorten the emergency response time of patients with multiple injuries,reduce mortality and MODS incidence,and improve patient prognosis.

关 键 词：多发伤 一体化 急诊 预后 

分 类 号：R64[医药卫生—外科学]