2019—2022年云南省道路交通伤死亡流行病学分析及院前救治策略研究

Epidemiological analysis and pre-hospital treatment strategy of road traffic deaths in Yunnan Province,2019-2022

目的分析2019—2022年云南省内院前因道路交通伤死亡患者的流行病学特征及其影响因素,为进一步制定预防措施、规范救治程序提供科学依据。方法回顾性分析2019年1月—2022年12月上报云南省紫云系统的因道路交通伤死亡患者数据,用构成比或率来描述流行病学及死亡病因等因素,组间比较采用χ2检验,探讨导致院前急救创伤患者死亡的影响因素。结果2019年—2022年云南省上报紫云系统的622例因道路交通伤死亡患者以男性(475例)为主,占76.37%;年龄6~96岁,平均48.3岁,高发年龄段为36~65岁的中年人群(51.61%),男女比例不同年龄段分组间比较差异无统计学意义(P>0.05)。大多数情况下(74.28%),救护车可以在事故发生后到达现场并在30 min内完成转移。导致死亡的主要原因为休克(24.92%)、严重颅脑损伤(22.19%)、肋骨骨折(16.56%)、肺挫伤引起的急性呼吸窘迫综合征(ARDS,11.41%)等,其中休克排名第一,不同疾病分组及在各年龄段分布比较差异无统计学意义(P>0.05)。结论云南省院前创伤死亡原因以休克、严重颅脑损伤等为主,且院前救治时间相对较长,因此对道路交通伤患者应尽早启动院前救护,加强院前、院内沟通,合理调配救治资源,减少创伤所致的死亡。

Objective To analyze the epidemiological characteristics and influencing factors of pre-hospital death following road traffic accidents(RTA)in Yunnan Province from 2019 to 2022,and to provide scientific evidence foRdeveloping preventive measures and standardizing rescue procedures.Methods Data of 622 pre-hospital deaths due to RTA reported to the Ziyun System of Yunnan Province from Jan.2019 to Dec.2022 were analyzed.The composition ratios oRrates were calculated.Chi-square test was used to explore the influencing factors of such deaths.Results Among the 622 deaths,the majority were males(n=475),accounting foR76.37%.The age ranged from 6 to 96 years,mean 48.3 years.The most affected group was middle-aged individuals aged between 36 and 65 years(51.61%).The gendeRcomposition revealed no statistically significant difference across different age groups(P>0.05).In most cases(74.28%),the ambulances were able to arrive at the scene and complete the transfeRwithin 30 min of the accident.The leading cause of death was shock(24.92%),followed by severe craniocerebral injury(22.19%),rib fractures(16.56%),and acute respiratory distress syndrome caused by pulmonary contusions(11.41%).The distribution of death causes showed no statistically significant difference across differen age groups(all P>0.05).Conclusion In Yunnan Province,the primary causes of pre-hospital deaths following RTA are shock and severe craniocerebral injuries,and the pre-hospital treatment time is relatively long.Therefore,early initiation of pre-hospital rescue foRRTA patients is crucial.Moreover,communication between pre-and in-hospital teams should be strengthened and allocation of rescue resources needs to be optimized to reduce pre-hospital RTA deaths.