便携式超声仪e-FAST技术在批量伤员军地联合院前救治中的应用研究  

The application of portable ultrasound e-FAST technology in pre hospital treatment of batch injured soldiers in military civilian joint hospitals

作　　者：王军峰 蒋建召 金海伟 李运正 邓应彪 WANG Junfeng;JIANG Jianzhao;JIN Haiwei;LI Yunzheng;DENG Yingbiao(Emergency Medicine Department,988 Hospital,Joint Logistic Support Force of Chinese People’s Liberation Army,Zhengzhou 450000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八八医院急诊医学科,河南郑州450000

出　　处：《广州医药》2025年第4期537-541,共5页Guangzhou Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230704)。

摘　　要：目的探讨便携式超声仪超声重点评估(e-FAST)技术在批量伤员军地联合院前救治中的应用效果。方法抽取2021年5月—2023年10月中国人民解放军联勤保障部队第九八八医院中心急诊科收治的80例批量伤员,均开展军地联合院前救治,按照治疗方案不同分为观察组和对照组,每组患者40例,其中对照组在救治现场行基于创伤严重程度(CRAMS)评分,进行常规急救处置,救护车返院后行CT检查并进行相应伤情治疗,观察组救治现场行CRAMS评分,进行常规急救处置,院前接诊医师在现场或救护车上使用便携式超声仪按照e-FAST流程检查相应部位,初步诊断后进行相应伤情治疗,对比两组患者治疗效果,两组患者诊断时间、初次医疗接触—进入手术室时间及入院诊断与出院时确定性诊断的符合率、两组患者治疗前后CRAMS评分及CRAMS≤8分抢救成功率。结果观察组治疗有效率为95.0%,对照组为85.0%,对比差异无统计学意义(χ^(2)=2.222,P=0.136);观察组患者的诊断时间(13.56±2.36)min、初次医疗接触—进入手术室时间(30.42±8.99)min均短于对照组[(23.64±5.69)、(52.27±12.60)min],差异有统计学意义(t=10.349、8.928,P<0.05);观察组患者入院诊断与出院时确定性诊断的符合为97.5%,对照组患者入院诊断与出院时确定性诊断的符合为95.0%,差异无统计学意义(χ^(2)=0.346,P=0.556);治疗后两组患者的CRAMS评分均升高,且观察组(9.87±2.62)分高于对照组(8.60±2.98)分,差异有统计学意义(t=2.024,P=0.046);观察组患者CRAMS≤8分的抢救成功率为97.50%,对照组CRAMS≤8抢救成功率为85.00%,观察组患者CRAMS≤8分的抢救成功率高于对照组(χ^(2)=3.914,P=0.048)。结论本研究从军地联合救治批量伤员切入,瞄准部队医院军民融合战略发展路线,本文针对便携式超声仪e-FAST应用范围前移,明显地提高急救人员院前救治能力,提高抢救成功率,值得临床参考。Objective To explore the application effect of portable ultrasound e-FAST technology in the pre hospita treatment of batch wounded soldiers in military civilian joint hospitals.Methods Eighty batch wounded patients admitted to the emergency department of 988 Hospital from May 2021 to October 2023 were selected,all of whom underwent military civilian joint pre hospital treatment.They were divided into an observation group and a control group according to different treatment plans,with 40 patients in each group.The control group received CRAMS scores at the treatment site for routine first aid treatment,CT scans afte ambulance return to the hospital for corresponding injury treatment,the observation group received CRAMS scores at the treatmen site for routine first aid treatment,and the pre-hospital attending physician used a portable ultrasound instrument to examine the corresponding parts on site or in the ambulance according to the e-FAST process.After preliminary diagnosis,corresponding injury treatment was carried out.The treatment effects of the two groups of patients were compared,and the diagnosis time and initia diagnosis of the two groups of patients were compared.The time from medical contact to entering the operation room,the compliance rate of discharge and admission diagnoses,the CRAMS score before and after treatment,and the success rate of rescue with CRAMS≤8 for both groups of patients were compared.Results The effective rate of treatment in the observation group was 95.0%,while in the control group it was 85.0%,which difference was not statistically significant(χ^(2)=2.222,P=0.136).The time to diagnosi(13.56±2.36)min,time to the operating room(30.42±8.99)min were shorter than that in the control group[(23.64±5.69),(52.27±12.60)min],with significant difference(t=10.349,8.928,P<0.05).The consistency between the admission diagnosis and the definitive diagnosis at discharge of the observation group patients was 97.5%,while the consistency of the contro group patients was 95.0%.There was no sign

关 键 词：院前救治 便携式超声仪 e-FAST技术 抢救成功率 

分 类 号：R605.97[医药卫生—急诊医学]