链式流程方法在院间危重患者转运中的运用

目的探讨链式流程转运方法在院间危重患者转运的价值。 方法回顾总结2011年11月至2014年11月采用链式转运的42例患者，与同期通过对照转运的80名患者进行比较。转运患者的年龄(49.38±18.52)岁，危重患者诊断包括：多发伤4例，高位截瘫3例，颈椎骨折2例，重型颅脑外伤2例，脓毒血症1例，特重度烧伤4例。比较两组转运里程数、时间、转运速率，转运的状态加重、平稳、死亡以及转运的肿瘤患者比较。 结果链式流程方法较一般急诊转运组相比时间更短(P<0.01)，转运的路程两组间比较有统计学意义(P<0.01)，链式转运的流程速率小于对照转运(P<0.01)。链式转运组病人的加重率(9.8%)小于对照转运组的加重率(40%)(P<0.01)。链式转运的平稳率(85.4%)好于对照转运(26.3%)(P<0.01)。链式流程转运的死亡率(2.4%)小于对照转运的死亡率(23.1%)(P<0.01)。两组患者转运肿瘤率比较，差异有统计学意义(P<0.01)，链式流程转运的死亡率(2.4%)小于对照转运的死亡率(23.1%)(P<0.01)。 结论链式流程转运方法在危重患者的途转运中较一般的转运模式具有更好的安全性及优越性，而加强链式转运人员对危重患者转运指南操作规程的培训和实施，是长途转运安全的保障。

The application of chain flow method in the inter-hospital transport of critically ill patients

ObjectiveTo explore the difference between the chain flow method and the control transport method. MethodsA review of 42 patients with chain transport from November 2011 to November 2014 was compared with 80 patients who had been transshipped with conventional method at the same period. The patient’s average age was (49.38±18.52) years old. The diagnosis of critically ill patients included: 4 multiple injuries, 3 high paraplegia, 2 cervical fractures, 2 Severe craniocerebral trauma, 1 sepsis, 4 severe burns. The transmission mileage, time and transfer rate between the two groups were compared. The status of the transfer was aggravated, stable, dead, and the condition of tumor patients who were transferred also were compared. ResultsCompared with the general emergency transport group, the chain procedure group had shorter time (P<0.01), and the difference of transit distance was statistically significant between the two groups (P<0.01). The transfer rate of the chain procedure group was lower than that of the control group (P< 0.01). The aggravation rate (9.8%) of the chain procedure group was lower than that of the control group (40%) (P<0.01). The steady rate of chain group (85.4%) was better than that of control group (26.3%) (P<0.01). The mortality rate of chain group (2.4%) was lower than that of control group (23.1%) (P<0.01). There was a statistically significant difference in the rate of tumor transport between the two groups (P<0.01). The mortality rate of chain group (2.4%) was lower than that of the control group (23.1%) (P<0.01). ConclusionsThe chain transport method has better safety and superiority than the conventional transport method in the transport of critical patients. Strengthening the training and implementation of the chain transporters’ guidelines for the transport of critical patients is safety protection of a long-distance transportation.