院前创伤团队启动(TTA)模式对严重四肢骨折患者救治及时性及预后观察  

A study on the timeliness and prognosis of prehospital trauma team initiation(TTA)mode in treating patients with severe limb fractures

作　　者：普伦庆 沈蓝 周志聪 何炳华 沈洁 PU Lunqing;SHEN Lan;ZHOU Zhicong(Department of Trauma Center,Yunnan Diannan Central Hospital,Mengzi,Yunnan,661199,China)

机构地区：[1]云南省滇南中心医院创伤中心,云南蒙自661199

出　　处：《实用手外科杂志》2024年第2期201-205,共5页Journal of Practical Hand Surgery

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(项目编号:202301AY070001-040);青岛大学医疗集团科研项目(项目编号:YLJT20222013)。

摘　　要：目的探究院前创伤团队启动(Trauma team activation,TTA)创伤救治模式对严重四肢骨折患者救治及时性及预后。方法选取2020年1月-2022年12月收治的严重四肢骨折患者84例,其中2020年1月-2021年5月为实施TTA模式前共纳入42例作为对照组,2021年6月-2022年12月为实施TTA后共纳入42例作为观察组,对比两组救治及时性指标、肢体功能、并发症以及骨密度指标恢复情况。结果与对照组相比,观察组感染、继发损伤、器官衰竭发生率降低,但对比数据差异不具有统计学意义(P>0.05);与对照组相比,观察组救治及时性指标、专科医生到达时间、特殊检查开始时间、急诊至手术时间、急诊停留时间均明显降低,住院时间明显缩短,差异具有统计学意义(P<0.05);与本组治疗前相比,患者PICP、Total-PINP水平明显升高,β-CTX明显降低,差异具有统计学意义(P<0.05)。与对照组相比,观察组治疗后骨代谢指标PICP、Total-PINP水平明显升高,差异具有统计学意义(P<0.05)。与对照组相比,观察组治疗后骨代谢指标β-CTX水平明显降低,差异具有统计学意义(P<0.05);与本组治疗前相比,患肢功能得分明显升高,差异具有统计学意义(P<0.05)。与对照组相比,观察组治疗后上肢、下肢功能得分明显升高,差异具有统计学意义(P<0.05);与对照组相比,观察组VAS评分、肿胀程度、骨折愈合时间均明显降低,差异具有统计学意义(P<0.05)。结论对于严重四肢骨折患者,开展院前创伤团队启动模式可有效缩短患者急救时间,以保证尽快开展手术治疗,促进患者康复,改善预后。Objective To explore the timeliness and prognosis of the pre hospital trauma team initiation(TTA)model in the treatment of patients with severe limb fractures.Methods Eighty four patients with severe limb fractures admitted to our hospital from January 2020 to December 2022 were selected.A total of 42 patients were included as the control group before implementing the TTA model from January 2020 to May 2021,and 42 patients were included as the study group after implementing the TTA model from June 2021 to December 2022.The recovery of timely treatment indicators,limb function,complications,and bone density indicators between two groups were compared.Results Compared with the control group,the incidence of infection,secondary injury,and organ failure in the study group patients decreased,but the difference in the comparative data was not statistically significant(P>0.05);Compared with the control group,the study group showed a significant decrease in timely treatment indicators,the arrival time of specialized doctors,the start time of special examinations,the time from emergency to surgery,and the stay time in emergency treatment.The hospitalization time of patients was significantly shortened,and the difference was statistically significant(P<0.05);Compared with before treatment in this group,the levels of PICP and Total PINP in patients were significantly increased,β-CTX significantly decreased,and the difference was statistically significant(P<0.05).Compared with the control group,the levels of bone metabolism indicators PICP and Total PINP in the study group were significantly increased after treatment,and the difference was statistically significant(P<0.05).Compared with the control group,the bone metabolism indicators in the study group after treatmentβ-The CTX level significantly decreased,and the difference was statistically significant(P<0.05);Compared with before treatment in this group,the limb function scores of patients were significantly higher,and the difference was statistically significant(P<0.0

关 键 词：四肢骨折 创伤团队启动 及时性 预后 

分 类 号：R687.3[医药卫生—骨科学]