老年人胸部外伤的院前干预

目的总结老年胸外伤患者院前急救经验。方法 60岁以上老年胸外伤患者78例,年龄60～89岁,平均(68.9±4.1)岁。致伤原因中跌伤与交通意外伤占80%;伤情分类中肋骨骨折发生率高达77%,约1/3合并有不同程度的头颅外伤;合并症中以心脑血管病为多。所有患者均在现场抢救后车载转送医院。结果呼救反应时间2～35min,平均(9.7±3.7)min;院前时间16min～4.5h,平均(38.5±9.5)min。无现场死亡及转送死亡;院内死亡5例,病死率为6.4%。结论只要掌握老年人胸部外伤的特点,进行快速、有效的院前干预,就能为进一步救治打下良好基础,为降低病死率和伤残率创造有利条件。

Prehospital care of elderly patients with thoracic trauma

Objective To summarize the experiences in prehospital care of elderly patients with thoracic trauma. Methods Seventy-eight patients with thoracic trauma,aged 60-89 （68.9±4.1） years,were transported to the hospital after pre-hospital emergency treatment. The traffic accidents and high falling were the two leading causes,which accounted for 80% of all trauma cases. The rib fracture accounted for 77%,1/3 of which also suffered head injury. Cardiovascular and cerebrovascular sequelae were the most common complications. Results Five cases dead in hospital （6.4%）,and no case dead on-scene or during transportation. The reflex time of first-aid ranged 2-35（9.7±3.7）min,and the prehospital time duration ranged 16 min-4.5 h（38.5±9.5） min. Conclusion Knowledge about characteristics of thoracic trauma in elderly patients and rapid and effective prehospital care are critical to improve the outcome of elderly patients with thoracic trauma.