院前院内无缝衔接一体化创伤救治

Integrated First Aid for Trauma Patients by Combining Pre-hospital Care with In-hospital Treatment

目的探讨院前院内一体化创伤急救新模式的可行性和必要性。方法对比研究院前院内联动、院内多学科创伤急救一体化救治的新模式治疗的116例创伤患者和到院后再行院内分诊、多科会诊、分科诊治的传统模式治疗的86例创伤患者,比较两种不同模式的急诊手术前时间和住院时间。结果新模式的急诊手术前时间和住院时间为(58±29)min及(28±15)d,传统模式为(125±60)min及(40±19)d,2组比较差异均有统计学意义(P均<0.01)。结论院前院内无缝衔接的一体化急救新模式比到院后院内分诊的传统模式大大缩短了急诊反应时间,提高了创伤后黄金1h的利用率,有利于急诊抢救和术前准备,为院内成功救治赢得了时间与机会,提示建立院前院内联动机制是可行和必要的。

Objective To explore the possibility and necessity of a new first aid model for trauma which integrates pre-hospital medial care with in-hospital treatment.Methods A comparison was made at the times of pre-operation preparation and hospitalization between two different trauma rescue models.From October in 2010 to October in 2011,116 patients were managed with the new integrated first aid model（pre-hospital care,emergency and multi-department consultations in the hospital） and 86 patients with traditional model（triage in emergency room,preliminary diagnosis by orthopedic doctors,multi-department consultations and medical care）.Results There was no significant difference between the two groups in pre-hospital index score（PHI）.The total times needed for the preparation before emergency operation and for hospitalization of the new model group were（58±29）min and（28±15）d respectively while those for the traditional model group were（125±60）min and（40±19）d.The differences between the two groups were statistical significant（P 〈 0.01）.Conclusion Both the time of pre-emergency operation and that of hospitalization for trauma patients are shortened through the application of the new trauma rescue model.Patients get better medical care and the efficiency of treatments is improved.