湖北省“三甲医院”和“二甲医院”创伤住院患者分析

Analysis of trauma patients admitted into grade 3 A and grade 2 A hospitals in Hubei Province

目的 对湖北省不同级别医院间创伤患者住院情况进行调查,为不同级别医院有重点地预防和干预创伤提供参考依据.方法 收集湖北省 5 所不同级别医院 2003 年创伤住院患者临床资料,对 5 所医院患者数量、性别、年龄段、伤者职业、致伤原因、Glasgow 昏迷评分(GCS)、损伤严重度评分(ISS)、手术及疾病结局的构成进行统计.结果 三甲医院收治患者数多于二级医院,性别以男性为主.三甲教学医院患者主要以无业人员、工人、其他职业为主,普通三甲医院及二级医院中农民亦占较高比例(30.40%～41.40%).患者致伤原因均以机动车撞伤为主,暴力及摔跌亦为主要致伤因素.三甲医院手术率、GCS 评分 3～8 分(昏迷)组比例、ISS 评分 16～25 分(重伤)组及≥25 分(严重伤)组比例均高于二级医院,且三甲教学医院以上比例高于普通三甲医院.治疗效果在不同级别医院间无明显差异.结论 不同医院间应根据收治患者特点采取有效预防和干预创伤发生的措施.

Objective To study the information of trauma patients between different rank hospitals in Hubei as a reference for prevention.Methods The data of number,sex,age,vocation,cause of injury,Glasgow coma score(GCS),injury severity score(ISS),operation rate,and treatment results of trauma patients admitted in 5 representative hospitals in Hubei Province,i.e.,Tongji Hospital,a Grade 3 A teaching hospital in Wuhan,General Hospital of Armed Police Forces of Hebei,a Grade 3 A hospital in Wuhan,and 3 Grade 2 A hospitals:Second Hospital of Jingmen City,People's Hospital of Jingshan County,and People's Hospital of Gong'an County,in 2003 were analyzed.Results The numbers of trauma patients admitted to the Grade 3 hospitals were significantly higher than those admitted to the Grade 2 hospitals.The proportion of male patients of trauma was significantly higher than that of the females patients in all hospitals except in the People's Hospital of Jingshan County.Major vocation of patients in tertiary-teaching hospitals were other vocation person,jobless and workers.Farmers accounted for aboput 30%～40% in the General Hospital of Armed Police Forces of Hebei and the Grade 2 A hospitals,but accounted fro less than 10% in the Tongji Hospital.The main cause of injury was traffic accident,and violence and fall were also common.The operation rate,rate of GCS 3～8,and rates of ISS 16～25 and ≥25 were all higher in the Grade 3 A hospitals,especially in the Grade 3 A teaching hospital,than in the Grade 2 A hospitals.The treatment outcomes were not significantly diffeeent among different hospitals.Conclusion There are differences in the number of trauma patientsand cause of trauma between the Grade 3 A and Grade 2 A hospitals.So different hospitals should develop their apecific strategies to deal with trauma.