院前护理干预对脑外伤患者预后的影响

Effects of Pre-hospital emergency care on Prognosis of Patients with Head Injury

目的分析院前护理干预对脑外伤患者预后的影响,表明规范化的护理干预能够降低患者伤残率和死亡率,是提高脑外伤患者抢救成功率的先决条件。方法对2005年2月-2011年12月因急性颅脑损伤来医院急诊1273例患者的临床资料进行回顾分析,其中自行来院的患者712例,由院前急救科"120"出诊接入的患者561例。结果自行来院组伤后至抢救介入时间(41.38±7.84)min,院前急救组抢救介入时间(13.16±3.44)min,两组相比差异有统计学意义(P<0.01);自行来院组患者开始抢救时患者GCS评分明显低于院前急救组,差异有统计学意义(P<0.01);而患者的瞳孔散大率高于院前急救组,差异有统计学意义(P<0.05);窒息发生率明显高于院前急救组,差异有统计学意义(P<0.01);病死率高于院前急救组,差异有统计学意义(P<0.05)。结论院前护理干预、规范化的院前抢救流程是提高脑外伤抢救成功的关键。

Objective To analyze the effects of pre-hospital emergency care on the prognosis of patients with head injury. Methods The clinical data of 1273 patients with acute head injury from February 2005 to December 2011 in our emergency were analyzed retrospectively, among them 712 cases came to hospitably themselves and 561 cases were taken in by pre-hospital emergency department. Results The duration time from the injury to the emergency treatment in the hospital was （41.38 ± 7.84 ） rain in patients who came to hospital by themselves, and （ 13.16 ±3.44） min in patients who were taken in by pre-hospital emergency department, the difference in the time was significance （ P 〈 0. 01 ） ; Glasgow Coma Scale in the group who came to hos-pital by themselves was obviously lower than that in the group who were taken in by pre-hospital emergency department （P 〈 0.01 ） ;the rate of patients with mydriasis or asphyxia in the group who came to hospital by themselves was obviously higher than that in the group who were taken in by pre-hospital emergency department（ P 〈 0. 01 and P 〈 0.01 ） ;and so was the mortality rate （ P 〈 0.05 ）. Conclusion Pre-hospital emergency care intervention and normalized pre-hospital emergency procedure are the keys to successfully rescue the patients with head injury.