探讨对颅脑外伤患者实施院前急救的预后影响

To Explore the Prognostic Impact of Pre-Hospital First Aid for Patients with Craniocerebral Trauma

目的探讨实施院前急救对颅脑外伤患者预后的影响。方法回顾性分析北京急救中心2018年5月至2020年1月转运的113例接受院前急救的颅脑外伤患者为研究对象并设为研究组,另选取同期115例直接送往宣武医院、天坛医院救治的颅脑外伤患者设为对照组。比较两组患者抢救时间、住院时间、治疗结果、预后各项指标评分、并发症发生率。结果研究组从受伤至入医院时间、术前准备时间、手术时间、住院时间均短于对照组,差异有统计学意义(P<0.05);研究组患者抢救存活率93.81%,明显高于对照组的79.13%,格拉斯哥预后评分(Glasgow Outcoma Scale,GOS)优于对照组,差异有统计学意义(P<0.05);经过抢救后存活患者中,研究组格拉斯哥昏迷量表(GCS)、神经功能缺损量表(NIHSS)评分均高于对照组,差异有统计学意义(P<0.05);经过抢救后存活患者中,研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论对颅脑外伤患者实施院前急救,可缩短救治时间,减少并发症的发生,有效改善患者预后。

Objective To investigate the prognostic value of pre-hospital first aid in patients with craniocerebral trauma.Methods Totally 113 patients with craniocerebral trauma who received pre-hospital first aid from Beijing Emergency Center from May 2018 to January 2020 were selected as the study group,and 115 patients who were directly sent to Xuanwu Hospital and Tiantan Hospital during the same period were selected as the control group.Rescue time,hospitalization time,treatment results,prognosis index scores and complication rate were compared between the two groups.Results The time from injury to hospital admission,preoperative preparation time,operation time and hospital stay in the study group were shorter than those in the control group,and the difference was statistically significant(P<0.05).The survival rate of the study group was 93.81%,which was significantly higher than that of the control group 79.13%,and the GOS was better than that of the control group(P<0.05).The GCS and NIHSS scores in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).Among the surviving patients after rescue,the incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Pre-hospital emergency treatment for patients with craniocerebral trauma can shorten the treatment time,reduce the occurrence of complications and effectively improve the prognosis of patients.