院前急救治疗对重型颅脑外伤患者神经功能损伤的影响

Effect of Pre-hospital Emergency Treatment on Neurologic Impairment in Patients with Severe Craniocerebral Trauma

目的:探讨院前急救治疗对重型颅脑外伤患者神经功能损伤的影响。方法:回顾性分析2020年1-12月北京急救中心救治的106例重症颅脑外伤患者的临床资料,根据入院前处理方法的不同分为观察组(进行专业的院前急救治疗后送入医院治疗,n=55)和对照组(直接送入医院进行治疗,n=51)。获取并比较两组治疗前后神经行为量表(NBNA)、格拉斯哥预后(GOS)、格拉斯哥昏迷量表(GCS)评分,比较两组抢救成功率、抢救总时间。结果:观察组、对照组抢救时间分别为(2.77±0.23)h、(3.58±0.31)h,观察组抢救时间短于对照组,差异具有统计学意义(t=15.352,P<0.001);观察组抢救成功率高于对照组,差异具有统计学意义(P<0.05);治疗后,两组NBNA、GCS、GOS评分均优于治疗前,且观察组NBNA、GCS、GOS评分优于对照组,差异具有统计学意义(P<0.05)。结论:在重型颅脑外伤患者危急抢救期间运用院前急救治疗,可缩短抢救时间,提高抢救成功率和预后。

Objective:To investigate the effect of pre-hospital emergency treatment on neurologic impairment in patients with severe craniocerebral trauma.Methods:A retrospective analysis was performed for the clinical data of 106 patients with severe craniocerebral trauma treated in Beijing Emergency Medical Center from January 2020 to December 2020.According to different pre-hospital treatment methods,the patients were divided into observation group(professional pre-hospital emergency treatment,followed by the treatment in hospitals,n=55) and control group(directly sent to the hospitals for treatment,n=51).The neurobehavioral scale(NBNA),Glasgow Outcome Scale(GOS),Glasgow Coma Scale(GCS) scores of the two groups were collected and compared before and after treatment,and the rescue success rate and total rescue time between the two groups were compared.Results:The rescue time of the observation group and the control group was(2.77±0.23) h and(3.58±0.31) h,respectively,and the observation group was shorter than the control group,with statistically significant differences(t=15.352,P<0.001);the rescue success rate of the observation group was higher than that of the control group,with statistically significant differences(P<0.05).After treatment,the scores of NBNA,GCS,GOS in two groups were higher than those before treatment,and the score of NBNA,GCS,GOS in the observation group were higher than those of the control group,with statistically significant differences(P<0.05).Conclusion:The use of pre-hospital emergency treatment during the emergency rescue of patients with severe craniocerebral trauma can shorten the rescue time and improve the success rate and prognosis.