摘要
目的研究创伤中心远程指导型急救模式在多发创伤合并多器官功能障碍综合征(MODS)患者中的应用价值.方法选取无锡市急救中心2017年4月—2018年4月创伤中心远程指导型急救模式实施前收治的47例多发创伤合并MODS患者纳入研究对象,设为对照组;另外选取本中心2018年5月—2019年5月创伤中心远程指导型急救模式实施后收治的47例多发创伤合并MODS患者纳入研究对象,设为观察组.对照组接受常规院外急救,观察组开展创伤中心远程指导型急救模式对患者进行院外救治.对比两组患者急救相关指标(急诊处理时间、受伤至入院时间、住院时间、重症加强护理病房(ICU)入住率)、急救结果(急救成功率、并发症发生率)及预后情况.结果观察组急诊处理时间、受伤至入院时间、住院时间、ICU入住率显著少于对照组,差异有统计学意义(P<0.05).观察组急救成功率、并发症发生率与对照组对比,差异无统计学意义(P>0.05).两组患者院期间共计死亡23.40%(11/47),其中观察组死亡10.64%(5/47)对照组死亡12.77%(6/47),两组患者死亡率对比无显著差异(P>0.05);两组患者随访期间未出现失访,两组患者随访期间未出现失访,观察组远期预后良好率57.45%与对照组56.10%对比,差异无统计学意义(P>0.05).结论对多发创伤合并MODS患者开展创伤中心远程指导型急救模式可减少急诊处理时间、受伤至入院时间、住院时间、ICU入住率,具有一定的临床应用价值,值得临床医师关注.
Objective To investigate the application value of trauma center remote guided first aid for patients with multiple trauma complicated with multiple organ dysfunction syndrome(MODS).Methods 47 patients with multiple trauma complicated with MODS accepted into the Wuxi Emergency Center April 2018—April 2018 before the Center adopted the remote guided first aid model underwent conventional pre-hospital first-aid by 120 staff,triage by emergency medical staff after being sent to the emergency center,and then corresponding specific treatment measures(control group).Another 47 age,cause of injury,and severity of injury-matched patients with multiple trauma complicated with MODS,accepted May 2018-May 2019,underwent treatment base<l on the remote guided first aid model focusing on green emergency path and timely examination and therapy(observation group).First aid time,hospitalization rate in intensive care unit(ICU),injury to admission time and other indexes were compared.First aid success rate,complication rate and other treatment results were observed.Follow up for 6 months.Results The emergency treatment time,hospital stay,and time from injury to hospitalization of the observation group were all significantly shorter than those of the control group(all P<0.05);and the ICU occupancy rate of the observation group was significantly lower than that of the control group(P<0.05).There were no statistically significant differences in the success rate of emergency treatment and the incidence of complications between these 2 groups(both P>0.05).The mortality of the observation group was 10.64%(5/47),not significantly different from that of the control group(12.77%,6/47,P>0.05).The good long-term prognosis rate of the observation group was 57.45%,not significantly different from that of the control group compared with in the control group,showing no statistical significance(56.10%,P>0.05).Conclusion For patients with multiple trauma combined with MODS,remote guided first aid reduces the emergency treatment time,injury to admission time,hospital stay,and ICU occupancy rate,thus has certain clinical application value and is worthy of clinicians’attention.
作者
杨凯涛
徐进宇
冯朝霞
YANG Kaitao;XU Jinyu;FENG Zhaoxia(Department of Emergency,Wuxi Emergency Center,Wuxi Jiangsu 214000,China)
出处
《中国急救复苏与灾害医学杂志》
2021年第4期370-372,384,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
多发创伤
多器官功能障碍综合征
院外急救
急救质量
Multiple trauma
Multiple organ dysfunction syndrome
Pre-hospital first aid
Quality of first aid
