颅脑损伤患者院前急救中应用颈托制动的效果分析

Effect analysis of applying cervical spine immobilization in pre-hospital care of patients with craniocerebral injury

目的 探讨颅脑损伤患者院前急救中应用颈托制动的临床疗效.方法 选取2012年1月～2013年12月本院急诊中心接诊的颅脑损伤患者160例为研究对象,根据院前急救措施不同分为观察组和对照组各80例,对照组采用传统的治疗方式进行救治;观察组在对照组的基础上加用颈托制动的方式进行救治.比较两组院前急救的救治效果、院内死亡率.随访6～12个月,采用卡诺夫斯基健康状况量表（KPS）评估患者的生活质量.结果 观察组的总有效率为73.75％,死亡率为20.00％;对照组的总有效率为57.50％,死亡率为23.75％,两组的总有效率差异有统计学意义（P＜0.05）,死亡率差异无统计学意义（P＞0.05）.两组上急救车时及到医院时的呼吸、心率、收缩压、舒张压及血氧饱和度差异有统计学意义（P＜0.05）;两组到医院时的呼吸、心率、收缩压、舒张压及血氧饱和度均较治疗前改善（P＜0.05）,且观察组改善效果优于对照组（P＜0.05）.两组治疗后的KPS评分均较治疗前提高（P＜0.05）,且观察组明显高于对照组（P＜0.05）.结论 颅脑损伤患者院前急救中应用传统治疗结合颈托制动的方式进行救治的效果优于传统的治疗方式.

Objective To investigate the clinical efficacy of applying cervical spine immobilization in pre-hospital care of patients with craniocerebral injury. Methods 160 patients with craniocerebral injury from January 2012 to December 2013 admitted into emergency center of our hospital were selected and were divided into the observation group （n=80） and control group （n=80）according to the different pre-hospital emergency measures.Traditional therapy was used in the control group,cervical spine immobilization was added to the observation group on the basis of the control group. Treatment effect of pre-hospital care and hospital mortality rate in the two groups was compared.Patients were followed-up for 6-12 months,the quality of life of patients was evaluated by Karnofsky performance scale. Results The total effective rate was 73.75%,the mortality rate was 20.00% in the observation group while the total effective rate was 57.50%, the mortality rate was 23.75% in the control group,and the difference of total effective rate was significant （P〈0.05）, the difference of mortality rate was not significant （P〉0.05）.The difference of respiration,heart rate,systolic blood pressure, diastolic blood pressure and oxygen saturation of the two groups was significant in ambulance and to the hospital （P〈0.05）; respiration,heart rate,systolic blood pressure,diastolic blood pressure and oxygen saturation of the two groups to the hospital was improved compared with that before treatment （P〈0.05）,and the effect of improvement in the observation group was more than that in the control group （P〈0.05）.KPS score of the two groups after treatment was improved than that before treatment （P〈0.05）,and the score in the observation group was higher than that of the control group （ P〈0.05）. Conclusion The effect of applying traditional treatment method combined with cervical spine immobilization to treat in pre-hospital care for patients with craniocerebral injury is better than the traditional treatment.