51例挤压伤院前急救分析

Analysis of Pre-hospital First Aid for 51 Cases of Crush Injury

目的了解院前急救医务人员对挤压伤和挤压综合征的认识和重视程度,探讨院前采取积极有效措施对挤压伤患者预后的影响。方法回顾性分析2004年9月-2014年8月51例挤压伤患者,记录院前急救医务人员认识和(或)采取了有效措施防治挤压综合征的例数。采取了有效防治措施的患者为治疗组,其余患者为对照组,比较两组患者严重并发症(挤压综合征和截肢)的发生率。结果 51例患者中,25例(49.0%)挤压伤被院前急救人员所认识,其中20例(39.2%)采取了有效防治措施;治疗组与对照组下肢严重创伤评分分别为(6.69±1.96)、(7.23±3.54)分,差异无统计学意义(P>0.05)。入院后治疗组发生严重并发症1例,为挤压综合征;对照组发生严重并发症10例,其中挤压综合征7例,截肢3例,治疗组严重并发症发生率为5.0%,明显低于对照组(32.3%),差异有统计学意义(P<0.05)。结论院前采取积极有效措施对防治挤压综合征和降低致残率具有显著的作用,但是目前院前急救人员对挤压伤和挤压综合征的认识和重视程度还是远远不够的。

Objective To understand the pre-hospital emergency medical staff＇s knowledge on crush injury and crush syndrome,and the influence of active and effective pre-hospital measures on the prognosis of patients with crush injury.Methods We retrospectively analyzed the clinical data of 51 patients with crush injury treated from September2004 to August 2014,and recorded the number of cases in which pre-hospital emergency medical staff recognized and/or took effective measures to control crush syndrome.Treatment group included those patients who accepted effective prevention and control measures,and the rest of the patients were included in the control group.We compared the two groups of patients in terms of the incidence of serious complications such as crush syndrome and amputation.Results Twenty-five cases（49.0%） of crush injury were recognized before the patients were admitted into the hospital,among whom 20（39.2%） accepted effective preventive and control measures.The mangled extremity severity score between the two groups of patients had no significant difference（6.69 ± 1.96 vs.7.23 ± 3.54,P〉0.05）.After being admitted into the hospital,the treatment group had one complication case of crush injury,while the control group had 10 complication cases including 7 of crush injury and 3 of amputation.The complication rate of the treatment group（5.0%） was significantly lower than that of the control group（32.3%,P〈0.05）.Conclusion Active and effective prehospital preventive and control measures are very important in the treatment of crush syndrome and reduction of morbidity,but the pre-hospital emergency personnel＇s knowledge of crush injury and crush syndrome is not enough.