急诊一体化救治严重胸伤为主多发伤患者的临床效果

Clinical efficacy of integrated emergency treatment for rescuing multiple trauma patients complicated with serious thoracic injury

目的总结急诊一体化救治严重胸伤为主多发伤患者的临床效果。方法急诊科收治严重胸伤为主的多发伤患者80例随机分为两组,每组40例。Ⅰ组实施急诊一体化救治:(1)加强有效的入院前急救;(2)规范病情评估和常规处理;(3)对胸部损伤实施及时针对性处理;(4)开放绿色通道,实施急诊手术。C组采用常规模式救治。比较两组患者急诊治疗效果。结果Ⅰ组抢救成功率为92.5%,高于C组的75.0%(P<0.05)。Ⅰ组急诊滞留时间和入院至急诊手术时间均短于C组(P<0.05)。Ⅰ组漏诊率和早期病死率分别为5.0%和2.5%,低于C组的20.0%和15.0%(P<0.05)。Ⅰ组治疗2周后总伤势损伤严重程度评分重伤占比为12.5%,低于C组的35.0%(P<0.05)。结论针对严重胸伤为主的多发伤患者,急诊一体化救治可缩短急诊滞留时间,为患者争取最佳抢救时机,临床抢救成功率较高。

Objective To summarize the clinical efficacy of integrated emergency treatment for rescuing multiple trauma patients complicated with serious thoracic injury.Methods Eighty patients with multiple trauma complicated with serious thoracic injury were treated with the conventional treatment mode（group C,40 cases）or with the integrated emergency treatment for rescuing（group Ⅰ,40 cases）,which included strengthening effective prehospital first aid,standardizing disease assessment and routine management,treating the thoracic injury timely and targetedly,and opening agreen channel for emergency operation.The clinical efficacy of rescuing was compared between two groups.Results The rescue success rate of groupⅠwas 92.5%,which was higher than 75.0% of group C（P〈0.05）.The delayed time for emergency treatment and the time from admission to emergency operation were shorter in group I than those in group C（P〈0.05）.The missed diagnosis rate and early mortality in group Ⅰ were 5.0% and 2.5%,which were lower than 20.0% and 15.0% in group C（P〈0.05）.The percentage of patients with serious injury evaluated by ISS score two weeks after trauma was less in group Ⅰ than that in group C（12.5% vs.35.0%）（P〈0.05）.Conclusion For rescuing multiple trauma patients complicated with serious thoracic injury,the integrated emergency treatment shows the advantages of shortening the delayed time for emergency treatment and the time from admission to emergency operation,striving the best rescue opportunity,and improving the rescue success rate.