院前时间对交通事故伤救治的影响

Analysis of pre-hospital time for traffic accident injuries

目的 :为加强郑州市交通事故伤的院前急救提供依据。方法 :采用流行病学方法对 12 32例交通事故伤的伤情和院前时间与结局进行分析。结果 :交通事故伤以青壮年多发 ,伤者以多发伤 (46 .8% )为主 ,颅脑和肢体为高发部位 ;颅脑和脏器的损伤重 ,ISS评分值显著高于其他部位 (F =14 .2 9,P <0 .0 0 0 1)。大部分伤者的院前时间(75 .9% )超过 1h ,且院前时间长短与伤者的预后有关 (趋势 χ2 =7.73,P =0 .0 18)。另外 ,伤者中 91.6 %有出血现象 ,仅有 1例患者在事故现场采取正确的止血措施。结论 :交通事故伤的伤情重且复杂 ,伤者院前时间过长对救治效果及伤者的预后影响很大。其次人们普遍缺乏急救知识和操作方法。建议实行各医院的急救资源合理调配 ,建立整体的急救医疗服务网络。同时 ,急需加强伤害急救知识。

Aim: To analyze the pre hospital situation for traffic accident injuries and to promote the emergency treatment levels for the injuries. Methods: Data for the injuries were collected by the review of medical records from the Emergency Medical Center of Zhengzhou City. Results: Traffic accident injuries occurred more commonly in the young and middle ages. 46.8% of the injuries were with multi sites.The injury most commonly happened in heads and legs. The ISS scores for injuries to the heads and viscera were significantly higher than those in other sites ( F =14.29, P <0.001). The pre hospital time for most injuries (75.9%) excessed 1 hour. The cure rates for injuries were increased with the decreasing of pre hospital time ( χ 2 for tread=7.73, P =0.018). Moreover, 91.6% of injuries had bleeding. Only one case took emergency help measures on the spot. Conclusions: Our study indicates that the injury situation for traffic accident is severe and complicated, and the pre hospital time had greats effect on the outcome of the injuries. We also found that people were lack of emergency help knowledge and the right operation techniques after the accident. We suggest that emergency treatment resources should be allocated reasonablely and effectively. Emergency medical service network of traffic accidents should be established in Zhengzhou city. Meanwhile, education and training programs on emergency help knowledge and techniques are ergently needed.