急诊流程化处理对控制颅脑损伤患者躁动的影响分析

Analysis of Emergency Routing Process on the Control of the Influence of Agitation in Patients with Craniocerebral Injury

目的探讨急诊流程化处理对控制颅脑损伤患者躁动的影响。方法选取2012-07-2013-12间我院确诊治疗的98例急诊颅脑损伤躁动患者,依据随机分配原则将其分为流程组和对照组,所有患者均给予常规格拉斯哥昏迷评分法（GCS）评分和Riker镇静、躁动评分（SAS）,给予对照组患者常规处理,给予流程组患者急诊流程化处理并对合适指征患者给予静脉输注曲马多0.3 mg/kg/h联合咪达唑仑0.03 mg/kg/h治疗,统计分析所有患者处理前后躁动分级、急救反应、躁动控制时间、躁动控制效果、SAS评分、撤药后清醒时间和并发症发生情况,应用Pearson分析法分析急救反应时间与躁动控制情况的相关性。结果处理后,流程组患者躁动控制率明显高于对照组,差异有统计学意义（P〈0.05）;流程组患者急救反应时间、躁动控制时间、撤药后清醒时间、并发症发生率明显低于对照组,前者SAS评分明显低于后者,差异有统计学意义（P〈0.05）;Pearson分析法结果显示,急救反应时间与躁动控制时间呈正相关（r1=6.723,P1〈0.001）,与SAS评分呈负相关（r2=0.468,P2=0.003）。结论急诊流程化处理可有效缩短急救时间和提高颅脑损伤患者躁动控制效果,有利于提高对患者的救治效果,值得临床作进一步推广。

Objective To discuss effect of emergency routing process on the control of the influence of agitation in patients with craniocerebral injury. Methods 98 patients with craniocerebral injury were selected in the hospital. According to the random distribution,all patients were divided into process group and control group,all patients were evaluated by Glasgow Coma Scale（ GCS） and Sedation- Agitation Scale（ SAS）. The control group were given conventional treatment. The process group were given emergency routing process,and patients with appropriate indications were given intravenous tramadol 0. 3 mg /（ kg / h） combined with midazolam 0. 03 mg /（ kg / h） treatment.Agitation,Agitation,control effect,awakeness time,complications after withdrawal,the correlation of emergency reaction time and Agitation control cases of all patients was used by Pearson analysis method. Results After processing,stir control rate in process group was obviously higher than control group（ P 〈0. 05）; Emergency response time,active control time,waking hours after withdrawal and complication rates in the process group was lower than that in the control group,and the former SAS scores was lower than the latter（ P〈 0. 05）;Pearson analysis results showed that the emergency response time and agitation control was positively correlated（ r1 = 6. 723,P1〈 0. 001）,and was negatively correlated with SAS score（ r2 = 0. 468,P2 = 0. 468）. Conclusion Emergency routing process can effectively shorten the first- aid time and improve the effect of agitation in patients with craniocerebral injury control to improve the treatment effect of patients.So it is worth further clinical promotion.