南通地区创伤救治影响因素及创伤单元建设现状调查与分析

Influencing factors of trauma treatment and the current situation of trauma unit construction in Nantong area

目的了解南通地区二、三级综合医院创伤单元建设现状和从事创伤救治的医务人员认知现状,为进一步提升本地区创伤救治能力建设提供依据。方法参考《江苏省创伤中心建设标准》基础上并结合专家意见,自行设计出南通地区院内创伤急救现况调查问卷,调查本地区34家二、三级医院内288名从事创伤救治工作的医务人员,对调查对象一般资料、所在医院的创伤救治工作影响因素、所在医院的院内创伤中心建设现状3个维度50个条目进行在线问卷调查。结果(1)医院的创伤救治工作影响因素:医师的水平和态度、损伤控制性技术开展及时性和重症医疗的参与等是最重要的影响因素。(2)院内创伤中心建设主要不足:50%的医院仍缺乏紧密型的创伤MDT,超过50%的医院未开展创伤救治信息化建设和质量管理;设施设备配置不足,包括杂交手术室建设、床旁影像学检查设施和自体血回输设施等。结论本地区医院创伤单元建设的同质化管理亟需进一步加强,尤其需加快信息化和质量管理体系建设,完善严重创伤急救的必备设施的配置。

Objective To understand the current situation of trauma unit construction and the cognition of medical staff engaged in trauma treatment in secondary and tertiary general hospitals in Nantong,and to provide basis for further improving the capacity building of trauma treatment in this area.Methods Based on the Standard for the Construction of Trauma Center in Jiangsu Province and combined with experts’opinions,a questionnaire was designed to investigate 288 medical staff engaged in trauma treatment in 34 secondary and tertiary hospitals in Nantong,and an online questionnaire survey was conducted with 50 items in three dimensions:the general information of the respondents,the influencing factors of trauma treatment in the hospital and the construction status of trauma center in the hospital.Results The level and attitude of doctors,the timeliness of injury control technology and the participation of critical care were the the most important influencing factors of trauma treatment in hospital.The construction of trauma center in hospital was mainly insufficient:50%hospitals still lack compact trauma MDT,and more than 50%hospitals have not carried out information construction and quality management of trauma treatment;facilities and equipments were not enough,including hybrid operating room construction,bedside image examination facilities and autologous blood transfusion facilities.Conclusion The homogeneous management of trauma unit construction in hospitals in this area needs to be further strengthened,especially the construction of informatization and quality management system,and the configuration of necessary facilities for severe trauma first-aid should be improved.