院前RTS评分促进早期医疗介入提高院前急救质量的探讨

The first-aid of the thoracic injuries based on RTS score

目的通过胸部创伤早期伤情特点的分析,探讨在院前急救中应用RTS评分法提高院前急救质量。方法 按是否运用院前RTS将早期胸伤163例分为1998年前、1999年后两组,评分量化早期伤情和生存概率。分组比较两组伤情,考察1999年后组的院前时间、院前出诊率和死亡率。结果163例早期伤情评分和生存概率均降低、运用院前RTS评分的1999年后组院前时间缩短,院前出诊率提高,虽然严重伤情比例高但死亡率较低。结论 胸伤早期的生理紊乱以RTS<7为重度损伤,可导致生存概率改变,院前急救中以RTS评分结果作为分拣转送和提前医学介入的依据,尽早纠正生理紊乱可降低重度胸外伤死亡率。作者建议在院前急救中用RTS评估伤情指导分拣转运,为早期医学干预提供客观指标,可提高急救医学质量和胸伤救治水平。

Objective Approach on improving quality of pre-registration emergency treatment by using RTS method after analyzing on early characteristics of thoracic injuries.Methods According to whether using RTS or not, divide early thoracic injuries 163 into two groups: pre-1998 group and after-1999 group, evaluate early condition and surviving probability.Compare the two groups conditions, study the after-1999 group, such as pre-registration time, visiting rate and death rate.Results 163 cases with low early condition evaluation and surviving probability , by using RTS method, the after-1999 group has short pre-registration time, high visiting rate. Although the rate of severe cases is high, the death rate is low. Conclusions Physiological disorder in early thoracic injuries, RTS < 7 severe cases may lead to surviving probability change. During pre-registration emergency treatment, RTS can be as a method to select and a pro of to early medical involvement. Early correcting physiological disorder may lower the death rate of severe thorax. The author advises that RTS can be used in pre-registration emergency treatment as a method to evaluate and select different cases. It can provide an objective proof to early medical interference. As a result, quality of emergency treatment and thoracic injuries treatment can be improved.