“5G云+医疗”物联网联动新模式在严重创伤患者救治中的应用效果

Application effect of the new model of"5G cloud plus medicine"network and linkage in treatment of patients with severe trauma

目的探讨"5G云+医疗"物联网联动新模式对提高严重创伤患者救治效果的作用。方法采用回顾性队列研究分析2016年11月至2020年11月山东第一医科大学附属青州医院收治的410例严重创伤患者的临床资料, 其中男258例, 女152例;年龄16~80岁[(45.7±16.1)岁]。损伤严重度评分(ISS)为17~55分[(28.1±7.6)分]。以启用"5G云+医疗"物联网联动新模式后(2018年11月1日至2020年11月30日)入院抢救的210例严重创伤患者为观察组, 以急诊传统救治模式(2016年11月1日至2018年10月31日)入院抢救的200例严重创伤患者为对照组。比较两组患者开始救治时间(患者到达医院后交接及开始抢救的时间)、完成CT检查时间(从接诊至完成CT检查时间)、接受输血时间(从输血申请至执行时间)、抢救室滞留时间、术后28 d ISS情况、输血患者比例、抢救成功率及病死率。结果观察组开始救治时间[(2.4±1.1)min]、完成CT检查时间[(29.1±10.3)min]、接受输血时间[(28.1±10.2)min]、抢救室滞留时间[(3.0±1.1)h]明显短于对照组的[(5.5±1.2)min、(42.8±10.1)min、(48.5±13.1)min、(5.0±1.4)h](P均<0.05或0.01)。观察组ISS为(18.7±2.8)分, 明显低于对照组的(22.1±3.4)分(P<0.05)。观察组输血患者比例为49.5%(104/210), 对照组为42.5%(85/200)(P>0.05)。观察组抢救成功率为99.0%(208/210), 明显高于对照组的93.0%(186/200)(P<0.05)。观察组病死率为4.3%(9/210), 明显低于对照组的8.5%(17/200)(P<0.05)。结论 "5G云+医疗"物联网联动新模式能有效缩短严重创伤患者的开始救治时间、CT检查时间、接受输血时间和抢救室滞留时间, 提高抢救成功率, 降低病死率, 值得进一步推广。

Objective To explore the effect of the new model of"5G cloud plus medicine"network and linkage in improving the therapeutic effect for patients with severe trauma.Methods A retrospective cohort study was conducted to analyze the clinical data of 410 patients with severe trauma admitted to Qingzhou People′s Hospital affiliated to Shandong First Medical University from November 2016 to November 2020.There were 258 males and 152 females,aged 16-80 years[(45.7±16.1)years].The injury severity score(ISS)ranged from 17 to 55 points[(28.1±7.6)points].A total of 210 patients with severe trauma were rescued by using the new model of"5G cloud plus medicine"network and linkage from November 1,2018 to November 30,2020(observation group),and another 200 patients with severe trauma were rescued by the traditional treatment mode from November 1,2016 to October 31,2018 were selected as the control group.Time to start rescue(time from admission to the start of rescue),CT examination time(time from consultation to completion of CT scan),time to receive blood transfusion(time from blood transfusion request to execution),residence time in emergency room,ISS at postoperative 28 days,proportion of patients with blood transfusion,success rate of rescue and mortality rate were compared between the two groups.Results Time to start rescue[(2.4±1.1)minutes],CT examination time[(29.1±10.3)minutes],time to receive blood transfusion[(28.1±10.2)minutes]and residence time in emergency room[(3.0±1.1)hours]in observation group were significantly shorter than those in control group[(5.5±1.2)minutes,(42.8±10.1)minutes,(48.5±13.1)minutes,(5.0±1.4)hours](all P<0.05 or 0.01).ISS was(18.7±2.8)points in observation group,significantly lower than(22.1±3.4)points in control group(P<0.05).Proportion of patients with blood transfusion was 49.5%(104/210)in observation group,similar with 42.5%(85/200)in control group(P>0.05).Success rate of rescue was 99.0%(208/210)in observation group,significantly higher than 93.0%(186/200)in control group(P<0.05).The mortality rate was 4.3%(9/200)in observation group,significantly lower than 8.5%(17/200)in control group(P<0.05).Conclusion For patients with severe trauma,the new model of"5G cloud plus medicine"network and linkage can effectively shorten the time to start rescue,CT examination time,time to receive blood transfusion and residence time in emergency room,improve the success rate of rescue and reduce the mortality rate,which is worthy of further promotion.