严重创伤急救程序-时间控制模式研究

The procedure of first aid and time-control mode in severe trauma

目的探讨在医院内建立严重创伤的急救程序-时间控制模式对严重创伤的救治效果。方法选取2013年1月-2013年12月期间在中山市人民医院就诊的严重创伤患者80例作为研究组,其中男性60例,女性20例;平均年龄37.8岁。致伤原因：道路交通伤58例,工程事故及高处坠落伤12例,意外伤害10例。2012年类似创伤患者64例作为对照组,其中男性48例,女性16例;平均年龄36.5岁。致伤原因：道路交通伤46例,工程事故及高处坠落10例,意外伤害8例。记录两组患者在急诊抢救室滞留时间、检查检验时间、就诊至手术时间。结果两组在性别、年龄、致伤机制及院前指数（PHI）等指标分布无统计学意义（P〉0.05）。急救程序-时间控制组死亡4例,死亡率为5%;对照组死亡6例,死亡率为9.37%（P〈0.05）。急救程序-时间控制组在急诊抢救室滞留时间、检查检验时间、就诊至手术时间较对照组明显缩短（P〈0.05）。结论建立严重创伤急救程序-时间控制模式可提高严重创伤的院内救治水平,规范院内救治中伤情评估、紧急手术和损害控制各环节流程,建立操作性强、效率较高的严重创伤院内救治管理模式,可显著提高救治成功率,降低死亡率。

Objective To explore the effects of the procedure of first aid and time-control mode in severe trauma. Methods Eighty patients with severe trauma in emergency department of Zhongshan People＇s hospital from Jan. 2013 to Dec. 2013 were labeled as research group. Sixty were males and 20 were females and the average age was 37. 8 years. Fifty-eight were resulted from vehicle accidents,12 from falls and 10 from accidents. Another64 trauma patients treated during 2012 were labeled as control group. Forty-eight were males and 16 were females and the average age was 36. 5 years. Forty-six were resulted from vehicle accidents,10 from falls and 8 from accidents. Residence time in the emergency department,inspection time and time from admission to operation in both groups were recorded. Results There was no statistical difference in aspects of gender,age,injury mechanism and PHI in both groups（ P〉0. 05）. Four patients died in the research group,with mortality rate of 5%; while six patients died in the control group,with mortality rate of 9. 37%（ P〈0. 05）. Compared with the control group,there was less time in emergency room care,inspection and interval from admission to operating room in the research group（ P〈0. 05）. Conclusion Establishment of the procedure of first aid and time-control mode in severe trauma is helpful to decrease the mortality ratio and to enhance the success rate of treatment. This method can effectively improve the treatment procedure in emergency department and help to promote the process of entirety,systematization and specialization of inner-hospital first aid in severe trauma.