急诊中心远程指导型急救模式对多发创伤合并多器官功能障碍综合征患者救治效果及凝血功能指标的影响

Effects of remote guidance first aid mode in emergency center on treatment effect and coagulation function indexes of patients with multiple trauma complicated with multiple organ dysfunction syndrome

目的分析急诊中心远程指导型急救模式在多发创伤合并多器官功能障碍综合征(MODS)患者中的应用价值。方法选取2019年4月至2021年4月我院收治的100例多发创伤合并MODS患者为研究对象,根据不同救治方法将其分为对照组(n=50,传统救治模式)和研究组(n=50,急诊中心远程指导型急救模式)。比较两组的应用效果。结果研究组的抢救反应时间、受伤至入院时间、院内急诊处理时间及住院时间短于对照组,24 h留观意外事件发生率低于对照组(P<0.05)。研究组的抢救成功率高于对照组(P<0.05);治疗5 d后,研究组的格拉斯哥昏迷指数(GCS)评分高于对照组,简明损伤定级法-损伤严重程度(AIS-ISS)评分低于对照组(P<0.05)。治疗5 d后,研究组的D-二聚体水平低于对照组,凝血酶原时间、活化部分凝血活酶时间长于对照组(P<0.05)。研究组患者家属对急救处理的满意度为90.00%,高于对照组的70.00%(P<0.05)。结论急诊中心远程指导型急救模式应用在多发创伤合并MODS患者救治中,能够实现损伤的早期控制,缩短救治时间,提高抢救成功率,显著改善患者的预后,提高患者家属对急救处理的满意度。

Objective To analyze the application value of remote guidance first aid mode in emergency center in patients with multiple trauma complicated with multiple organ dysfunction syndrome(MODS).Methods A total of 100 patients with multiple trauma complicated with MODS admitted in our hospital from April 2019 to April 2021 were selected as the research objects.According to different treatment methods,the patients were divided into control group(n=50,traditional treatment mode)and study group(n=50,remote guidance first aid mode in emergency center).The application effects of the two groups were compared.Results The rescue reaction time,time from injury to admission,emergency treatment time and hospitalization time in the study group were shorter than those in the control group,and the incidence of accidents in 24 h was lower than that in the control group(P<0.05).The success rate of rescue in the study group was higher than that in the control group(P<0.05);after 5 d of treatment,the Glasgow Coma Scale(GCS)score of the study group was higher than that of the control group,and the Abbreviated Injury Scale-Injury Severity Score(AIS-ISS)score was lower than that of the control group(P<0.05).After 5 d of treatment,the D-dimer level in the study group was lower than that in the control group,and the prothrombin time and activated partial thromboplastin time were longer than those in the control group(P<0.05).The patients family members'satisfaction with emergency treatment in the study group was 90.00%,which was higher than 70.00%in the control group(P<0.05).Conclusion Remote guidance first aid mode in emergency center applied in the treatment of patients with multiple trauma complicated with MODS can realize the early control of injury,shorten the treatment time,improve the success rate of rescue,and significantly improve the prognosis of patients and satisfaction of patients'families with first aid treatment.