重型颅脑外伤合并多发伤的院前急救探究

Pre-hospital First Aid for Severe Craniocerebral Trauma Combined with Multiple Injuries

目的回顾探讨重型颅脑外伤合并多发伤患者的院前急救措施及效果。方法回顾分析2017年9月—2019年9月在该院急诊科接受抢救的86例重型颅脑外伤合并多发伤患者作为该次研究对象,所有患者经CT扫描诊断均与WHO规定的重型颅脑外伤诊断标准相符,均为合并性并发外伤。依据随机数表法将其分成对照组和观察组各43例。对照组患者实施常规急救处理,观察组患者实施精准院前急救措施,对比两组患者格拉斯哥预后评分评定结果以及两组送诊时间、开始手术时间。结果格拉斯哥预后评分显示,通过两种不同抢救方式,观察组患者经院前抢救后的恢复良好、中度残疾、重度残疾、植物状态以及病死率分别占总例数的30.23%、41.86%、13.95%、9.30%、4.65%,各项结果优于对照组患者各项评分结果的11.63%、11.63%、32.56%、25.58%、18.60%,两组患者各项对比差异有统计学意义(Z=-3.767,P<0.05);观察组送诊时间(1.7±0.2)h低于对照组(3.1±0.2)h,差异有统计学意义(t=26.458,P<0.05);观察组患者接受手术的时间(2.4±0.3)h低于对照组(3.7±0.6)h,差异有统计学意义(t=12.080,P<0.05)。结论对重型颅脑损伤合并多发伤患者进行院前急救,可有效缩短送诊时间和手术时间,通过开通绿色通道,可为患者赢得最佳手术治疗时间,进而改善预后,降低病死率,提升患者的生存质量。

Objective To retrospectively explore the prehospital emergency measures and effects of patients with severe head trauma combined with multiple injuries.Methods A retrospective analysis of 70 patients with severe head trauma combined with multiple injuries who were rescued in the emergency department of the hospital from September 2017 to September 2019 were the subjects of this study.All the patients diagnosed by CT scans were consistent with the severe conditions specified by the WHO.The craniocerebral traumas were consistent with the diagnostic criteria,and they were all complicated and complicated with trauma.According to the random number table method,they were divided into a control group and an observation group,each with 43 cases.The patients in the control group received routine emergency treatment,and the patients in the observation group received precise pre-hospital emergency measures.The Glasgow prognosis score evaluation results of the two groups were compared and the two groups were sent to a clinic time,start time of surgery.Results The Glasgow prognosis score showed that through two different rescue methods,patients in the observation group recovered well after prehospital rescue,moderately disabled,severely disabled,vegetative state,and mortality accounted for 30.23%,41.86%,and 13.95%,9.30%,4.65%of the total number of cases,respectively,the results were better than the 11.63%,11.63%,32.56%,25.58%,18.60%of the scores of the control group patients.The comparison between the two groups of patients was significantly different and statistically significant(Z=-3.767,P<0.05);the delivery time of the observation group(1.7±0.2)h was lower than that of the control group(3.1±0.2)h,the difference was statistically significant(t=26.458,P<0.05),the observation group received surgery time(2.4±0.3)h was lower than that of the control group(3.7±0.6)h,and the difference was statistically significant(t=12.080,P<0.05).Conclusion Pre-hospital emergency treatment for patients with severe head injury combined with multiple injuries can effectively shorten the delivery time and operation time.By opening the green channel,the patient can win the best surgical treatment time,thereby improving the prognosis,reducing the mortality rate,and improving the quality of life of patients.