一体化创伤急救模式在急诊严重多发伤救治中的应用  

Application of integrated trauma emergency mode in the treatment of severe multiple injuries in Emergency Department

作　　者：王德震 梁娟娟 王红梅 刘畅 WANG De-zhen;LIANG Juan-juan;WANG Hong-mei;LIU Chang(Emergency Department,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan,CHINA;School of Physical Education,Xinxiang Medical College,Zhengzhou 450000,Henan,CHINA;College of Basic Medicine,Henan University of Science and Technology,Luoyang 471000,Henan,CHINA)

机构地区：[1]郑州大学附属郑州中心医院急诊科,河南郑州450000 [2]新乡医学院体育学院,河南郑州450000 [3]河南科技大学基础医学院,河南洛阳471000

出　　处：《海南医学》2024年第23期3387-3391,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ2019051)。

摘　　要：目的探讨一体化创伤急救模式在急诊严重多发伤救治中的应用效果。方法回顾性分析2021年3月至2024年3月郑州大学附属郑州中心医院急诊科接诊的110例严重创伤患者的病历资料,按不同的急救模式将患者分为对照组53例和研究组57例。对照组患者采用传统急救模式,研究组患者采用创伤中心一体化创伤急救模式。治疗结束后,比较两组患者建立静脉通路时间、完成检查时间、急诊滞留时间、急诊至急诊手术室时间及住院时间;并采用创伤程度评分(ISS)对两组患者抢救前、治疗结束后的损伤严重程度进行评估;比较两组患者多器官功能障碍综合征(MODS)发生率、弥散性血管内凝血(DIC)发生率、急性生理与慢性健康(APACHEⅡ)评分、转诊率及抢救成功率;比较两组患者创伤合并症的发生情况。结果研究组患者建立静脉通路时间、完成检查时间、急诊滞留时间、急诊至急诊手术室时间、住院时间分别为(12.34±2.03)min、(23.13±3.33)min、(62.32±15.04)min、(69.31±10.51)min、(13.40±2.13)d,明显短于对照组的(15.11±2.98)min、(36.11±4.25)min、(70.03±20.02)min、(80.20±13.10)min、(15.14±2.05)d,差异均有统计学意义(P<0.05);研究组患者治疗结束后的轻伤占比为84.21%,明显高于对照组的64.15%,重伤、严重伤的占比分别为10.53%、1.75%,明显低于对照组的26.42%、13.21%,差异均有统计学意义(P<0.05);研究组患者的MODS发生率、DIC发生率、APACHE II评分、转诊率分别为5.26%、3.51%、(8.75±1.10)分、0,明显低于对照组18.87%、15.09%、(14.21±1.68)分、9.43%(P<0.05),抢救成功率为96.49%,明显高于对照组的84.91%,差异均有统计学意义(P<0.05);研究组患者的创伤合并症发生率为7.02%,明显低于对照组的22.64%,差异有统计学意义(P<0.05)。结论创伤中心一体化创伤急救模式在急诊严重多发伤抢救中的效果显著,可提高急救效率,改善患者损伤严重程度,Objective To explore the application effect of integrated trauma emergency mode in the treatment of severe multiple injuries in Emergency Department.Methods The medical records of 110 patients with severe trau-ma admitted to the Emergency Department of Zhengzhou Central Hospital Affiliated to Zhengzhou University from March 2021 to March 2024 were retrospectively analyzed.The patients were divided into a control group(n=53)and a study group(n=57)according to different emergency modes.The traditional emergency mode was adopted in the control group,while the integrated trauma emergency mode was adopted in the study group.The time of establishing venous ac-cess,total body examination time,emergency retention time,emergency to operating room time,and length of hospital stay of the two groups were compared after treatment;the Injury Severity Score(ISS)was used to evaluate the injury se-verity of patients in the two groups before rescue and after treatment;the incidence of multiple organ dysfunction syn-drome(MODS),disseminated intravascular coagulation(DIC),Acute Physiology and Chronic Health Evaluation(APACHEⅡ)score,referral rate,and rescue success rate were compared between the two groups.The occurrence of complications in the two groups was recorded.Results The time of establishing venous access,general examination time,emergency retention time,emergency to operating room time,and length of hospital stay in the study group were(12.34±2.03)min,(23.13±3.33)min,(62.32±15.04)min,(69.31±10.51)min,and(13.40±2.13)d,respectively,which were significantly shorter than(15.11±2.98)min,(36.11±4.25)min,(70.03±20.02)min,(80.20±13.10)min,and(15.14±2.05)d in the control group(P<0.05).The percentage of patients with minor injuries in the study group after treatment was 84.21%,which was significantly higher than 64.15%in the control group,and the percentages of severe and signifi-cantly severe injuries were 10.53%and 1.75%,which were significantly lower than 26.42%and 13.21%in the control group(P<0.05).The incidence of MO

关 键 词：急诊 严重多发伤 应用效果 创伤中心 一体化 急救模式 

分 类 号：R605.97[医药卫生—急诊医学]