摘要
目的探讨院前急救创伤评分(CRAMS评分)的应用方法及其在院前急救患者诊治中的应用价值。方法回顾性选择我院2019年6月至2020年6月急救中心诊治的120例创伤患者为研究对象,根据院前急救方法将其分为C组(60例)和CRAMS组(60例),分别实施常规院前急救、CRAMS评分指导的院前急救。分别统计C组和CRAMS组患者转运时间、转运成功率和诊治成功率;并探讨CRAMS组患者转运途中并发症、危急症状、急诊后去向及临床预后与CRAMS评分的关系。结果CRAMS组转运成功率、诊治成功率分别为91.67%、85.00%,均高于C组的76.67%、66.67%(P<0.05)。在CRAMS评分上,CRAMS组发生并发症的患者CRAMS评分低于无并发症组(P<0.05),CRAMS组发生呼吸困难、低血压、休克、心房颤动者CRAMS评分均低于未合并组(P<0.05),CRAMS组急诊后离院组患者CRAMS评分>急诊后收住专科病房组>急诊后收住ICU组(P<0.05),CRAMS组治愈者>伤残者>死亡者(P<0.05)。结论CRAMS评分与院前急救患者转运途中并发症、危急症状、急诊后去向及临床预后密切相关,于创伤患者院前急救中通过CRAMS评分方法的指导制定针对性的急救干预,对提高患者诊治效果及预后改善具有重要的意义。
Objective To explore the application of pre-hospital emergency trauma score(CRAMS score)and its application value in the diagnosis and treatment of pre-hospital emergency patients.Methods A total of 120 trauma patients diagnosed and treated in the emergency center of our hospital from June 2019 to June 2020 were retrospectively selected as the research objects.According to the pre-hospital emergency treatment methods,they were divided into group C(n=60)and group CRAMS(n=60),and received conventional pre-hospital emergency treatment and pre-hospital emergency treatment guided by CRAMS score respectively.Transport time,transport success rate and diagnosis and treatment success rate of patients in C group and CRAMS group were analyzed.The relationship between the CRAMS score and the complications,critical symptoms,emergency destination and clinical prognosis in the CRAMS group was investigated.Results The success rates of transport and diagnosis and treatment in CRAMS group were 91.67%and 85.00%,respectively,which were higher than 76.67%and 66.67%in C group(P<0.05).In terms of CRAMS score,the CRAMS score of patients with complications in the CRAMS group was lower than that in the non-complication group(P<0.05),and the CRAMS score of patients with dyspnea,hypotension,shock and atrial fibrillation in the CRAMS group was lower than that in the non-complication group(P<0.05).The CRAMS score of patients in the CRAMS group who were discharged from hospital after emergency treatment>those admitted to specialized ward after emergency treatment>those admitted to ICU after emergency treatment(P<0.05),and the patients in the CRAMS group who were cured>those with disability>those who died(P<0.05).Conclusion CRAMS score is closely related to complications,critical symptoms,post-emergency destination and clinical prognosis of pre-hospital emergency patients.It is of great significance to develop targeted emergency intervention through the guidance of CRAMS score method in pre-hospital emergency treatment of trauma patients,which can improve the diagnosis and treatment effect and prognosis of patients.
作者
叶家朋
YE Jiapeng(Department of Medical,Xiamen Medical Emergency Center,Xiamen 361021,China)
出处
《中国医药指南》
2022年第32期72-74,78,共4页
Guide of China Medicine
关键词
院前急救
院前急救创伤评分
急救创伤评分
并发症
危急症状
预后
Pre-hospital first aid
Pre-hospital trauma score
CRAMS score
Complications
Critical symptoms
Prognosis
