一体化急诊创伤外科运作模式初期实践的可行性分析

Feasibility study in the initial practices of the integrated emergency trauma-surgery working model

目的:评价以普外科为基础的初期一体化急诊创伤外科运作模式在诊疗相关患者方面的效用和所收治患者的主要特点,并与以往分科共诊模式进行比较。方法:采集急诊创伤外科成立之前和之后各2年半收治入院的155名急诊外科创伤患者,对其伤情特点、收治效率、转归情况等方面进行比较。结果:所有收入院患者中以男性患者为主,平均年龄47.92岁,交通事故伤为致创首因,腹部、颅面部、前胸部为易伤部位。就诊和入院的高峰时间分布为8点至24点及12点至20点。创伤组手术患者入院前滞留时间(t=2.115,P<0.05)、入院至手术时间(t=2.381,P<0.05)、投诉纠纷事件(χ2=7.232,P<0.01)均短于或少于传统组。结论:以普外科为基础的初期一体化急诊创伤外科运作模式能够缩短患者入院或至急诊手术时间,提高伤员救治的及时性和连贯性,有利于减轻目前三级医院普遍较为严重的急诊患者的滞留问题及降低医疗投诉纠纷等隐患。可能对改善患者预后及缩短住院时间有所帮助,具有可行性。

Objective： To analyze the effect of the initial integrated emergency trauma-surgery working model based on general surgery and patient＇s condition when compared with traditional model. Method： One hundred and fifty-five emergency trauma patients admitted to our hospital during 2 years before and after the foundation of e- mergency trauma surgery ward were selected, and the traumatic condition, treating efficiency and outcome were compared between the two groups. Result：There is a predominance of men in these patients whose average age is 47.92. Traffic accident is the main cause, and abdomen, craniofacial and front thoracic are predilection sites. The peak visit time is from 8 to 24 oclock while the peak admission time is from 12 to 20 oclock. The dwell time before admission（ t = 2.115, P〈0.05 ）, time cost during treatment（t = 2.381, P〈0.05） and complaint events（x^2= 7. 232, P〈O. 01） are shorter or less in trauma-surgery group than that of the control group. Conclusion：The initial inte- grated emergency trauma surgery working model based on general surgery is feasible to shorten the time cost dur- ing treatment and improve the consistency of rescue. This model is beneficial to relieve the overcrowding and reduce complaints. It is supposed to be helpful for improving prognosis and decreasing hospitalization duration.