院前院内一体化管理模式对多发伤患者急救质量及预后的影响

Influence of pre-hospital and intra-hospital integrated management mode on the quality of emergency care and prognosis of patients with multiple injuries

目的:研究院前院内一体化管理模式对多发伤患者的临床预后和急救质量的影响分析。方法:选取2019年9月至2021年10月本院急诊科收治的(CRAMS评分<9分的重度创伤)多发伤患者80例,依据其他急救分站和本院急救分站所实施的不同的急救创伤管理模式分为对照组40例和研究组40例,其中对照组行创伤院前院内急救模式,研究组行院前院内一体化管理模式;观察并比较两组有效救治时间、急诊处理时间、住院天数、入住ICU和受伤至医院时间、住院费用、并发症发生率、住院前病死率、住院病死率和急救满意结果。结果:研究组有效救治时间明显短于对照组(P<0.05);研究组住院时间、住院费用、入住ICU率、住院前病死率、住院病死率均较对照组有所降低(P<0.05),且研究组并发症发生率为15.00%(6/40),明显低于对照组的30.00%(12/40)(P<0.05)。研究组受伤到院时间与对照组比较差异无统计学意义(P>0.05);研究组接警速度、反应时间、服务态度、技术操作和诊治流程评分与对照组比较差异无统计学意义(P>0.05),但研究组电话沟通、现场处理、组织协调、院内衔接、收费合理评分均明显高于对照组(P<0.05)。结论:院前院内一体化管理模式不仅可缩短多发伤患者的住院时间,还可降低死亡率、入住ICU率和住院前后病死率,提高了急诊救治满意度,对预后效果有明显提升。

Objective:To analyze the influence of the integrated management model in the front hospital of the institute on the clinical prognosis and first aid quality of patients with multiple injuries.Methods:A total of 80 patients with multiple injuries(severe trauma with CRAMS score<9 points)admitted to the emergency department of our hospital from September 2019 to October 2021 were selected.The first aid trauma management mode was divided into a control group of 40 cases and a research group of 40 cases.The control group was treated with pre-hospital and in-hospital emergency care mode,and the research group was treated with pre-hospital and in-hospital integrated management mode.The effective treatment time,emergency treatment duration,length of hospital stay,ICU stay and injury-to-hospital time,hospital costs,complication rates,pre-hospital mortality,in-hospital mortality,and first aid satisfaction outcomes were observed and compared between the two groups.Results:The effective treatment time of the research group was significantly shorter than that of the control group(P<0.05);the hospitalization time,hospitalization costs,ICU admission rate,pre-hospital mortality rate,and hospitalization mortality rate of the research group were all lower than those of the control group(P<0.05),and the incidence of complications in the research group was 15.00%(6/40),which was significantly lower than 30.00%(12/40)in the control group(P<0.05).There was no significant difference between the research group and the control group in the time of injury arrival at the hospita l(P>0.05);there was no significant difference between the research group and the control group in terms of speed,reaction time,service attitude,technical operation and diagnosis and treatment process scores(P>0.05),but the scores of telephone communication,on-site handling,organizational coordination,in-hospital connection,and reasonable fees in the research group were significantly higher than those in the control group(P<0.05).Conclusion:The integrated pre-hospital and in-hospital management model can not only shorten the hospital stay of patients with multiple injuries,but also reduce the mortality rate,ICU admission rate,and pre-hospital mortality rate,improve the satisfaction of emergency treatment,and significantly improve the prognosis.