以创伤医师为主导的多学科协作模式对血流动力学不稳定骨盆骨折的早期救治效果评估  

Evaluation of early treatment effectiveness for hemodynamically unstable pelvic fractures led by trauma physicians using multidisciplinary team approach

作　　者：周瑶 罗盛强 ZHOU Yao;LUO Shengqiang(Department of Emergency,Beijing Jishuitan Hospital Guizhou Hospital,Guizhou Province,Guiyang 550014,China)

机构地区：[1]北京积水潭医院贵州医院急诊科,贵州贵阳550014

出　　处：《中国当代医药》2024年第12期70-73,78,共5页China Modern Medicine

摘　　要：目的探讨以创伤医师为主导的多学科协作(MDT)模式对血流动力学不稳定骨盆骨折的早期救治效果。方法选取2020年7月至2023年7月北京积水潭医院贵州医院收治的280例血流动力学不稳定骨盆骨折患者作为研究对象,根据救治模式分为观察组(140例)和对照组(140例)。观察组实施创伤医师为指导的MDT救治模式,对照组实施传统救治模式。比较两组死亡率、入院时及入院后生命体征、实验室指标、治疗情况及诊疗时间。结果两组入院后24 h内死亡率比较,差异无统计学意义(P>0.05);两组入院时收缩压、心率、血红蛋白、血小板计数、血乳酸比较,差异无统计学意义(P>0.05);入院后6、24 h,观察组收缩压高于对照组,观察组心率低于对照组,差异有统计学意义(P<0.05);入院后24 h,观察组血红蛋白、血小板计数高于对照组,观察组血乳酸低于对照组,差异有统计学意义(P<0.05);观察组输血量低于对照组,ICU住院时间、急诊通过时间、早期救治时间短于对照组,差异有统计学意义(P<0.05)。结论创伤医师为主导的MDT模式在血流动力学不稳定骨盆骨折的早期救治中,可有效提高患者生命体征的稳定性,缩短治疗相关时间。Objective To explore the effectiveness of early treatment of hemodynamically unstable pelvic fractures led by trauma physicians using multidisciplinary team(MDT)approach.Methods A total of 280 patients with hemodynamically unstable pelvic fractures from July 2020 to July 2023 admitted to Beijing Jishuitan Hospital Guizhou Hospital were selected as the study objects.They were divided into observation group(140 cases)and control group(140 cases).The observation group was treated with MDT model guided by trauma physicians,while the control group received traditional treatment.The mortality rate,vital signs at admission and after admission,laboratory indicators,treatment conditions,and diagnostic and treatment times were compared between the two groups.Results The mortality rates within 24 hours after admission between the two groups showed no significant statistical differences(P>0.05).There were no significant differences in systolic blood pressure,heart rate,hemoglobin,platelet count,and blood lactate levels at admission between the two groups(P>0.05).At 6 hours and 24 hours after admission,the systolic blood pressure of the observation group was higher than that of the control group,and the heart rate of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).At 24 hours after admission,the hemoglobin and platelet counts of the observation group were higher than those of the control group,and the blood lactate levels of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The transfusion volume of the observation group was lower than that of the control group,and the ICU stay duration,emergency department throughput time,and early treatment time were shorter than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The MDT model led by trauma physicians can effectively improve the stability of vital signs in patients with hemodynamical

关 键 词：骨盆骨折 血流动力学不稳定 多学科协作模式 创伤医师 早期救治 

分 类 号：R683.3[医药卫生—骨科学]